Provider Demographics
NPI:1497471007
Name:GERALDINE GABRIEL LLC
Entity Type:Organization
Organization Name:GERALDINE GABRIEL LLC
Other - Org Name:PSYCHE WELLNESS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP, FNP
Authorized Official - Phone:973-283-5985
Mailing Address - Street 1:300 MAIN ST STE 21-638
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2369
Mailing Address - Country:US
Mailing Address - Phone:973-283-5985
Mailing Address - Fax:531-200-7505
Practice Address - Street 1:300 MAIN ST STE 21638
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2369
Practice Address - Country:US
Practice Address - Phone:973-302-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty