Provider Demographics
NPI:1912214271
Name:GAMBARDELLA, JANET GAIL (ST)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:GAIL
Last Name:GAMBARDELLA
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:GAIL
Other - Last Name:RICCIARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ST
Mailing Address - Street 1:16 MOHAWK LANE
Mailing Address - Street 2:
Mailing Address - City:MANALPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:917-502-0082
Mailing Address - Fax:
Practice Address - Street 1:16 MOHAWK LN
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-4612
Practice Address - Country:US
Practice Address - Phone:917-502-0082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003922-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist