Provider Demographics
NPI:1194191718
Name:GAO, JINGJING
Entity Type:Individual
Prefix:
First Name:JINGJING
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 E 66TH ST
Mailing Address - Street 2:APT 1H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6930
Mailing Address - Country:US
Mailing Address - Phone:216-924-8230
Mailing Address - Fax:
Practice Address - Street 1:446 E 66TH ST
Practice Address - Street 2:APT 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6930
Practice Address - Country:US
Practice Address - Phone:216-924-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker