Provider Demographics
NPI:1851389621
Name:GAYER, JONAS D (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JONAS
Middle Name:D
Last Name:GAYER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8146 188TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1065
Mailing Address - Country:US
Mailing Address - Phone:718-454-3764
Mailing Address - Fax:718-454-3764
Practice Address - Street 1:8146 188TH ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1065
Practice Address - Country:US
Practice Address - Phone:718-454-3764
Practice Address - Fax:718-454-3764
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0329361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3040114OtherOXFORD
NYR032936-B37Medicare UPIN
NYP3040114OtherOXFORD
NYR032936Medicare UPIN
NYN40252Medicare ID - Type Unspecified