Provider Demographics
NPI:1043782972
Name:ADAMITIS, GABRIELLE (PSYD)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:ADAMITIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:FROHLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 CREEK VIEW PATH
Mailing Address - Street 2:
Mailing Address - City:KIRKVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13082-9442
Mailing Address - Country:US
Mailing Address - Phone:701-989-9404
Mailing Address - Fax:
Practice Address - Street 1:800 IRVING AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2716
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043842A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical