Doctor Name: | DR. GAIL A. WASSERMAN |
NPI Number: | 1770616195 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 006794-1 |
Business Practice Address: | 2 Hornbeam Ln Kinnelon, NJ - 074052443 |
Business Phone Number: | 2125435296 |
Business Fax Number: | 2125431000 |
Mailing Address: | 2 Hornbeam Ln, KINNELON |
State: | NJ |
Postal Code: | 074052443 |
Phone Number: | 2125435296 |
Fax Number: | 2125431000 |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 006794-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |