Provider Demographics
NPI:1760548838
Name:NOVELLI, GIANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GIANNA
Middle Name:
Last Name:NOVELLI
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 1:101 SAN CARLOS ST
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-6256
Mailing Address - Country:US
Mailing Address - Phone:800-330-8306
Mailing Address - Fax:800-330-8306
Practice Address - Street 1:101 SAN CARLOS ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-6256
Practice Address - Country:US
Practice Address - Phone:908-476-0129
Practice Address - Fax:800-330-8306
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00057800103TC1900X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082062Medicare ID - Type UnspecifiedEMPIRE MEDICARE PART B