Provider Demographics
NPI:1164135794
Name:GAER, NEIL (LADC-1)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:GAER
Suffix:
Gender:M
Credentials:LADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-3420
Mailing Address - Country:US
Mailing Address - Phone:860-324-9313
Mailing Address - Fax:
Practice Address - Street 1:1 LINDEN DR
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3420
Practice Address - Country:US
Practice Address - Phone:860-324-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)