Provider Demographics
NPI:1871352674
Name:LO PICCOLO, GABRIELLA ANNA
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:ANNA
Last Name:LO PICCOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IVY LN
Mailing Address - Street 2:
Mailing Address - City:RIVER VALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6654
Mailing Address - Country:US
Mailing Address - Phone:551-497-8776
Mailing Address - Fax:
Practice Address - Street 1:300 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5318
Practice Address - Country:US
Practice Address - Phone:201-368-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01171500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist