Most Relevant Information
Provider Data
| NPI Number: | 1003467663 |
| Provider Name: | GIBELLE ACOSTA LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 107631-01 |
Most Important Dates
| Enumeration Date: | 09/25/2019 |
| Last Updated: | 09/25/2019 |
Provider Practice Location
4600 BROADWAY RM 132
NEW YORK
NY
100402102
Practice Location Phone/Fax
| Phone: | 1256928592 |
| Fax: | 2125447561 |
Provider Mailing Location
4600 BROADWAY RM 132
NEW YORK
NY
100402102
Provider Mailing Phone/Fax
| Phone: | 1256928592 |
| Fax: | 2125447561 |