Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gabrielle Gannon

Individual provider Physician Assistant · NPI 1669169835

Gabrielle Gannon is a Physician Assistant in Staten Island, New York. Qualified in 2023, 3 years ago. Practices with Excel Urgent Care of Wantagh PLLC, a 39-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
3
Licensed in
NJ, NY
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

2960 Victory Blvd
Staten Island, NY 10314-6605
Phone: (718) 370-2014
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 7001 Amboy Rd, Staten Island, NY 10307-1444 — (347) 838-6991
  • 3894 Richmond Ave, Staten Island, NY 10312-5111 — (347) 630-7985

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 031131 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00826400 (NJ)

Record details

NPI number1669169835
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 19, 2023
Last updated in NPPESNovember 8, 2024
Certification dateNovember 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Excel Urgent Care Of Wantagh Pllc — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Staten Island