Provider Demographics
NPI:1992826275
Name:GAUS, VALERIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:GAUS
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 1:64 E GATE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5109
Mailing Address - Country:US
Mailing Address - Phone:631-692-9750
Mailing Address - Fax:631-692-9751
Practice Address - Street 1:64 E GATE DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-5109
Practice Address - Country:US
Practice Address - Phone:631-692-9750
Practice Address - Fax:631-692-9751
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012090103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV5J062Medicare PIN