Healthcare Provider Details

I. General information

NPI: 1538246137
Provider Name (Legal Business Name): JOHN F GASIEWSKI LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE OVERLOOK HOSPITAL
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

25 LINDSLEY DR STE 100 ATTN: C. LAMPRON
MORRISTOWN NJ
07960-4456
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-2970
  • Fax: 908-522-4888
Mailing address:
  • Phone: 973-451-0246
  • Fax: 973-451-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05311900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: