Provider Demographics
NPI:1245959279
Name:MARIE GAGLIANO PHD LLC
Entity type:Organization
Organization Name:MARIE GAGLIANO PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-433-6221
Mailing Address - Street 1:21 CARTERET RD
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1853
Mailing Address - Country:US
Mailing Address - Phone:973-943-8974
Mailing Address - Fax:
Practice Address - Street 1:265 US HIGHWAY 46 STE 202
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1820
Practice Address - Country:US
Practice Address - Phone:973-433-6221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty