Provider Demographics
NPI:1932902160
Name:JUNIEWICZ, GABRIELA (PA-C)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:JUNIEWICZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-3036
Mailing Address - Country:US
Mailing Address - Phone:201-417-4271
Mailing Address - Fax:
Practice Address - Street 1:199 BROAD ST STE 2A
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2635
Practice Address - Country:US
Practice Address - Phone:973-748-4583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00913900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant