Provider Demographics
NPI:1992920136
Name:GABRIEL, CHRISTINE LEIGH (PTA)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LEIGH
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 ASBURY RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7104
Mailing Address - Country:US
Mailing Address - Phone:609-926-5421
Mailing Address - Fax:609-653-4425
Practice Address - Street 1:54 SHARP ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2444
Practice Address - Country:US
Practice Address - Phone:856-327-2700
Practice Address - Fax:856-327-6796
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00148000314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility