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NPI 1205949286

NPI 1205949286 : GAIL M GUNBERG PHD : SPARTA, NJ

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General NPI Number Information
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    NPI Number           |    1205949286
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    Entity Type          |    Individual 
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    Provider Name        |    GAIL M GUNBERG PHD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/16/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    270 SPARTA AVE SUITE 203
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    City                 |    SPARTA
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    State                |    NJ
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    Zip                  |    07871
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    Country              |    US
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    Telephone            |    973-702-0838
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    Fax                  |    973-702-0838
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Provider Business Mailing Address
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    Address Line         |    23 DENNII RD 
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    City                 |    LAFAYETTE
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    State                |    NJ
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    Zip                  |    07848
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    Country              |    US
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    Telephone            |    973-702-0838
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    Fax                  |    973-702-0838
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    2830
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    License Number State |    NJ
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