Provider Demographics
NPI:1366720591
Name:BLABER, GILLIAN THERESA (MS)
Entity type:Individual
Prefix:MISS
First Name:GILLIAN
Middle Name:THERESA
Last Name:BLABER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MINEOLA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4064
Mailing Address - Country:US
Mailing Address - Phone:516-663-2657
Mailing Address - Fax:516-663-8297
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4064
Practice Address - Country:US
Practice Address - Phone:516-663-2657
Practice Address - Fax:516-663-8297
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS