Provider Demographics
NPI:1760183636
Name:CARVALHO, GABRIELLA MORENO AZEVEDO (PA-C)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MORENO AZEVEDO
Last Name:CARVALHO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-247-7220
Mailing Address - Fax:856-247-7768
Practice Address - Street 1:200 BOWMAN DR STE E385
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9638
Practice Address - Country:US
Practice Address - Phone:856-247-7220
Practice Address - Fax:856-247-7768
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2025-09-10
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00766600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant