Provider Demographics
NPI:1982156832
Name:MOREL, GEHAN LIALE
Entity Type:Individual
Prefix:
First Name:GEHAN
Middle Name:LIALE
Last Name:MOREL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LOWRY CT APT A
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-3349
Mailing Address - Country:US
Mailing Address - Phone:908-477-5554
Mailing Address - Fax:
Practice Address - Street 1:916 MAIN AVE STE 1A
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-8545
Practice Address - Country:US
Practice Address - Phone:973-773-0334
Practice Address - Fax:973-773-0336
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4310501363LA2100X
NJ26NJ00773500363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care