Provider Demographics
NPI:1396000709
Name:FISKUS, GILA
Entity Type:Individual
Prefix:MRS
First Name:GILA
Middle Name:
Last Name:FISKUS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:GILA
Other - Middle Name:
Other - Last Name:SZANZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:504 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1467
Mailing Address - Country:US
Mailing Address - Phone:347-522-9127
Mailing Address - Fax:
Practice Address - Street 1:504 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1467
Practice Address - Country:US
Practice Address - Phone:347-522-9127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-13-13456103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst