Provider Demographics
NPI:1750830964
Name:GERBER, EVA
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:GERBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 NORTHERN BLVD
Mailing Address - Street 2:SUITE300A
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1506
Mailing Address - Country:US
Mailing Address - Phone:516-365-1144
Mailing Address - Fax:516-626-3333
Practice Address - Street 1:1025 NORTHERN BLVD
Practice Address - Street 2:SUITE300A
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1506
Practice Address - Country:US
Practice Address - Phone:516-365-1144
Practice Address - Fax:516-626-3333
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074256-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical