Provider Demographics
NPI:1205949286
Name:GUNBERG, GAIL M (PHD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:M
Last Name:GUNBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 DENNII RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848
Mailing Address - Country:US
Mailing Address - Phone:973-702-0838
Mailing Address - Fax:973-702-0838
Practice Address - Street 1:270 SPARTA AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:973-702-0838
Practice Address - Fax:973-702-0838
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2830103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
J023022OtherCHAMPUS
J023022OtherCHAMPUS