Active NPI
Thomas John Gambino Jr.
- Psychologist
- Union City, NJ
National Provider Identifier
1669139333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00656800
- Practice address
- 206 36TH St Apt 301
Union City, NJ 07087-6075 - Phone
- (732) 228-4766
- NPI assigned
- Nov 17, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35SI00656800 | NJ | Primary |
Addresses
Primary practice location
206 36TH St Apt 301
Union City, NJ 07087-6075
Mailing address
206 36TH St Apt 301
Union City, NJ 07087-6075
Phone (732) 228-4766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 25, 2023 through Sep 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00656800 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1669139333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 36TH ST APT 301",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070876075",
"telephone_number": "732-228-4766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 36TH ST APT 301",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070876075",
"telephone_number": "732-228-4766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBINO",
"first_name": "THOMAS",
"middle_name": "JOHN",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-17",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00656800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.