Provider Demographics
NPI:1508930991
Name:LUTHRA, GAGAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:GAGAN
Middle Name:
Last Name:LUTHRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 GUNTHER LOOP
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-7355
Mailing Address - Country:US
Mailing Address - Phone:732-873-7377
Mailing Address - Fax:732-873-7377
Practice Address - Street 1:18 GUNTHER LOOP
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-7355
Practice Address - Country:US
Practice Address - Phone:732-873-7377
Practice Address - Fax:732-873-7377
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00248000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional