1730343153 NPI number — MRS. SIMONE GILA GAMPEL RD,CDE

Table of content: MRS. SIMONE GILA GAMPEL RD,CDE (NPI 1730343153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730343153 NPI number — MRS. SIMONE GILA GAMPEL RD,CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAMPEL
Provider First Name:
SIMONE
Provider Middle Name:
GILA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD,CDE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730343153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 FLORAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW PROVIDENCE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07974-1557
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-273-4300
Provider Business Mailing Address Fax Number:
908-790-6576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 N VILLAGE AVE STE 211
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKVILLE CENTRE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11570-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-714-3743
Provider Business Practice Location Address Fax Number:
607-203-0639
Provider Enumeration Date:
07/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  929599 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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