| NPI | 1538840590 |
|---|---|
| Former Name | GABRIELLE RILEY CICCARELLI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 065234) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2023042682) |
| 122300000X Dentist (Licence: NE 7966) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2026-02-18 |