Basic Information
| Provider Information | |||||||||
| NPI: | 1336771914 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRUPI | ||||||||
| FirstName: | GABRIELA | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 ROUTE 46 E STE 450 | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070041583 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735593700 | ||||||||
| FaxNumber: | 9735598650 | ||||||||
| Practice Location | |||||||||
| Address1: | 271 GROVE AVE STE A | ||||||||
| Address2: | |||||||||
| City: | VERONA | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070441731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732392600 | ||||||||
| FaxNumber: | 9732390482 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2020 | ||||||||
| LastUpdateDate: | 09/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MP00549700 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.