Provider Demographics
NPI:1740202803
Name:ZAMBELLI, GRACE C (PHD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:C
Last Name:ZAMBELLI
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 1:2 KINDRED COURT
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920
Mailing Address - Country:US
Mailing Address - Phone:908-580-9691
Mailing Address - Fax:
Practice Address - Street 1:10 COLUMBA ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-3868
Practice Address - Country:US
Practice Address - Phone:908-580-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100364700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist