Provider Demographics
NPI:1528023611
Name:GAESSER, MARILYN EILEEN (APRN)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:EILEEN
Last Name:GAESSER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 NEW RD
Mailing Address - Street 2:BUILDING C, SUITE 203
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4274
Mailing Address - Country:US
Mailing Address - Phone:973-227-0029
Mailing Address - Fax:
Practice Address - Street 1:239 NEW RD
Practice Address - Street 2:BUILDING C, SUITE 203
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4274
Practice Address - Country:US
Practice Address - Phone:973-227-0029
Practice Address - Fax:973-433-4354
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC08777200363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS68237Medicare UPIN
NJ021988Medicare PIN