Provider Demographics
NPI:1255640231
Name:GABERT, STEPHANIE ANN (MSPT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:GABERT
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 MIRABELLE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6119
Mailing Address - Country:US
Mailing Address - Phone:516-640-5228
Mailing Address - Fax:
Practice Address - Street 1:900 MIRABELLE AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6119
Practice Address - Country:US
Practice Address - Phone:516-640-5228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022755225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist