Provider Demographics
NPI:1669208229
Name:LUXEUS, GETHRO
Entity type:Individual
Prefix:
First Name:GETHRO
Middle Name:
Last Name:LUXEUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2612
Mailing Address - Country:US
Mailing Address - Phone:646-571-7898
Mailing Address - Fax:
Practice Address - Street 1:1018 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6000
Practice Address - Country:US
Practice Address - Phone:646-571-7898
Practice Address - Fax:973-629-1418
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health