Provider Demographics
NPI:1518994623
Name:GERBER, LAURIE JO (MS, ATC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:JO
Last Name:GERBER
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 ROYAL OAKS CT
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2287
Mailing Address - Country:US
Mailing Address - Phone:732-309-5053
Mailing Address - Fax:732-564-9021
Practice Address - Street 1:2 WORLDS FAIR DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1369
Practice Address - Country:US
Practice Address - Phone:732-309-5053
Practice Address - Fax:732-564-9021
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9896742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer