Individual provider Active NPI

Gail Burack, PHD

  • Psychologist
  • New Brunswick, NJ
National Provider Identifier
1457491946
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI002552 Issued in NJ
Practice address
97 Paterson St
Robert Wood Johnson Professional Center
New Brunswick, NJ 08901-2160
Phone
(732) 235-7888
NPI assigned
Feb 7, 2007
Last updated
Mar 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI002552 NJ Primary

Addresses

Primary practice location

97 Paterson St
Robert Wood Johnson Professional Center
New Brunswick, NJ 08901-2160

Mailing address

66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
8675708MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI002552NJMDPsychologist

Interoperability endpoints

  • Direct secure messaging: gburack17954@epicdirect.rwjbh.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1457491946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 PATERSON ST",
            "address_2": "ROBERT WOOD JOHNSON PROFESSIONAL CENTER",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012160",
            "telephone_number": "732-235-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURACK",
        "first_name": "GAIL",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI002552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8675708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.