Healthcare Provider Details

I. General information

NPI: 1881503571
Provider Name (Legal Business Name): GISELLE HENRIQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384 TRENTON AVE APT 1I
PATERSON NJ
07503-1043
US

IV. Provider business mailing address

384 TRENTON AVE APT 1I
PATERSON NJ
07503-1043
US

V. Phone/Fax

Practice location:
  • Phone: 201-406-9332
  • Fax:
Mailing address:
  • Phone: 201-406-9332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07335800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: