Provider Demographics
NPI:1134365059
Name:GELB, CAROL S (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:S
Last Name:GELB
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:LOUISE
Other - Last Name:SINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:49 LAKE SHORE DR. S.
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869
Mailing Address - Country:US
Mailing Address - Phone:862-432-6653
Mailing Address - Fax:
Practice Address - Street 1:242 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:908-704-9696
Practice Address - Fax:908-704-0097
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00037200231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ016828Medicare PIN