1114646155 NPI number — GABRIELLA CONTI WHNP

Table of content: GABRIELLA CONTI WHNP (NPI 1114646155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114646155 NPI number — GABRIELLA CONTI WHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONTI
Provider First Name:
GABRIELLA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZABBO
Provider Other First Name:
GABRIELLA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
WHNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1114646155
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 HILLSIDE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DRACUT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01826-3649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-888-4460
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 RESEARCH PL STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHELMSFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01863-2455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-256-1858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  RN2326584 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)