Healthcare Provider Details

I. General information

NPI: 1245135136
Provider Name (Legal Business Name): GIA RONDOLET MA, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 FRANKLIN ST
MORRISTOWN NJ
07960-8635
US

IV. Provider business mailing address

205 FARNHAM AVE
LODI NJ
07644-1003
US

V. Phone/Fax

Practice location:
  • Phone: 862-753-5825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37AC00995800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: