Provider Demographics
NPI:1043056773
Name:GORIN, GABRIELLE EVE (MED)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:EVE
Last Name:GORIN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 MCKEAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2530
Mailing Address - Country:US
Mailing Address - Phone:305-495-4176
Mailing Address - Fax:
Practice Address - Street 1:100 S BROAD ST STE 623
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1058
Practice Address - Country:US
Practice Address - Phone:215-402-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health