Healthcare Provider Details

I. General information

NPI: 1255503157
Provider Name (Legal Business Name): SUZANNE JANE GELB PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 KALAKAUA AVE SUITE 3203
HONOLULU HI
96826-3766
US

IV. Provider business mailing address

1750 KALAKAUA AVE SUITE 3203
HONOLULU HI
96826-3766
US

V. Phone/Fax

Practice location:
  • Phone: 808-943-2994
  • Fax: 808-356-0549
Mailing address:
  • Phone: 808-943-2994
  • Fax: 808-356-0549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY587
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: