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General NPI Number Information
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NPI Number | 1306544473
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Entity Type | Individual
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Provider Name | GARY C. JEAN MSN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 233 MOUNT AIRY RD STE 100
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2338
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Country | US
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Telephone | 973-304-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 600 STATION DR APT 625
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City | AVENEL
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State | NJ
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Zip | 07001-1868
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Country | US
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Telephone | 347-824-5767
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F405456-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11024714
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ01463500
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License Number State | NJ
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