Provider Demographics
NPI:1154464642
Name:BELLUARDO, GAIL (MSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:BELLUARDO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 US HIGHWAY 46
Mailing Address - Street 2:BUILDING A, 2ND FLOOR, SUITE 12
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4904
Mailing Address - Country:US
Mailing Address - Phone:973-334-5291
Mailing Address - Fax:
Practice Address - Street 1:1279 US HIGHWAY 46
Practice Address - Street 2:BUILDING A, 2ND FLOOR, SUITE 12
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4904
Practice Address - Country:US
Practice Address - Phone:973-334-5291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000251001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTIS362OtherOXFORD HEALTH PLANS
CTIS362OtherOXFORD HEALTH PLANS