MEDICARE: MRS. DEANNA P. GITLOW LICENSED COUNSELOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	37PC00331900	NJ

General Provider Information

NPI Number	:	1336287978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEANNA P. GITLOW LICENSED COUNSELOR

Provider Business Mailing Address
First Line	:	33 WOOD AVE S
Second Line	:	6TH FLOOR
City	:	ISELIN
State	:	NJ
Zip	:	08830-2735
Country	:	US
Telephone Number	:	732-536-0076
Fax Number	:	732-972-8846

Provider Business Practice Location Address
First Line	:	33 WOOD AVE S
Second Line	:	6TH FLOOR
City	:	ISELIN
State	:	NJ
Zip	:	08830-2735
Country	:	US
Telephone Number	:	732-536-0076
Fax Number	:	732-972-8846

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2007
Last Update Date	:	07/08/2007

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