Provider Demographics
NPI:1770127318
Name:GBAPP INC
Entity type:Organization
Organization Name:GBAPP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEUDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-366-8255
Mailing Address - Street 1:1470 BARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-3237
Mailing Address - Country:US
Mailing Address - Phone:203-366-8255
Mailing Address - Fax:203-338-8453
Practice Address - Street 1:1470 BARNUM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-3237
Practice Address - Country:US
Practice Address - Phone:203-366-8255
Practice Address - Fax:203-338-8453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty