MEDICARE: GESOMINA VERONICA MAGLIO PH.D.

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	1041C0700X	Clinical Social Worker	44SC00136900	NJ

General Provider Information

NPI Number	:	1962572719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GESOMINA VERONICA MAGLIO PH.D.

Provider Business Mailing Address
First Line	:	7 CHUKKA WAY
Second Line	:
City	:	FAR HILLS
State	:	NJ
Zip	:	07931-2477
Country	:	US
Telephone Number	:	908-781-0864
Fax Number	:	908-781-9805

Provider Business Practice Location Address
First Line	:	FAR HILLS CENTER
Second Line	:	RT 202
City	:	FAR HILLS
State	:	NJ
Zip	:	07931
Country	:	US
Telephone Number	:	908-791-0864
Fax Number	:	908-781-9805

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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