Provider Demographics
NPI:1245054907
Name:GAJDA, ELIZABETH KHRISTINE (MED, EDS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KHRISTINE
Last Name:GAJDA
Suffix:
Gender:F
Credentials:MED, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 BROWNHOME RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-8312
Mailing Address - Country:US
Mailing Address - Phone:330-842-2160
Mailing Address - Fax:
Practice Address - Street 1:770 BROWNHOME RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-8312
Practice Address - Country:US
Practice Address - Phone:330-842-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1435006103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool