Provider Demographics
NPI:1871832972
Name:GERBER, ADRIA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADRIA
Middle Name:M
Last Name:GERBER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ADRIA
Other - Middle Name:M
Other - Last Name:GERBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:101 BUTTONWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746
Mailing Address - Country:US
Mailing Address - Phone:631-697-3423
Mailing Address - Fax:631-629-4445
Practice Address - Street 1:340 VETERANS MEMORIAL HWY STE 12
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4300
Practice Address - Country:US
Practice Address - Phone:631-697-3423
Practice Address - Fax:631-486-8400
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2019-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019962-1103T00000X, 103TC1900X, 103TC2200X, 103TS0200X
NY019962-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool