Provider Demographics
NPI:1063204386
Name:MORENO-KING, GABRIELA ELENA (DPT)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:ELENA
Last Name:MORENO-KING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N BEAUREGARD ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2943
Mailing Address - Country:US
Mailing Address - Phone:339-293-2690
Mailing Address - Fax:
Practice Address - Street 1:4225 ALTAMONT PL STE 102
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3039
Practice Address - Country:US
Practice Address - Phone:301-932-5299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist