Provider Demographics
NPI:1912639659
Name:BUFFALOE, GAYE (MA, LCADC)
Entity Type:Individual
Prefix:
First Name:GAYE
Middle Name:
Last Name:BUFFALOE
Suffix:
Gender:F
Credentials:MA, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 FIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-2804
Mailing Address - Country:US
Mailing Address - Phone:862-227-3164
Mailing Address - Fax:
Practice Address - Street 1:1026 FIELD AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-2804
Practice Address - Country:US
Practice Address - Phone:908-239-9656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00115300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)