Individual provider Active NPI

Mary Ann Therese Gdula, PHD,RN,CAS

  • Clinical Psychologist
  • Morristown, NJ
National Provider Identifier
1487859385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00258000 Issued in NJ
Practice address
66 Maple Ave
Morristown, NJ 07960-5250
Phone
(973) 538-7288
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00258000 NJ Primary

Addresses

Primary practice location

66 Maple Ave
Morristown, NJ 07960-5250

Mailing address

15 Windsor Way
Basking Ridge, NJ 07920-2519

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)
Not enrolled
Credentials
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
35SI00258000NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487859385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WINDSOR WAY",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MAPLE AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079605250",
            "telephone_number": "973-538-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GDULA",
        "first_name": "MARY ANN",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "PHD,RN,CAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00258000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.