Organization Active NPI

Gerson Hagovsky Antonelli & Altman, LLC

  • Clinical Psychologist
  • Livingston, NJ
National Provider Identifier
1679779524
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1880 Issued in NJ
Legal business name
GERSON HAGOVSKY ANTONELLI & ALTMAN, LLC
Practice address
22 Old Short Hills Rd
Suite 216
Livingston, NJ 07039-5604
Phone
(973) 994-7403
Fax
(973) 994-9152
NPI assigned
Jun 26, 2007
Last updated
Aug 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Authorized official

Name
Ms. Ellen Scott, MBA
Title
Accountant
Phone
(973) 994-7403

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9120 NJ
Clinical Psychologist 103TC0700X 3183 NJ
Clinical Psychologist 103TC0700X 1880 NJ Primary

Addresses

Primary practice location

22 Old Short Hills Rd
Suite 216
Livingston, NJ 07039-5604

Mailing address

22 Old Short Hills Rd
Suite 216
Livingston, NJ 07039-5604
Phone (973) 994-7403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060228000063 NJ Part B Supplier - Clinic/Group Practice 4486660503 Receives reassigned benefits from 1 practitioner
Practice locations: Livingston, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1679779524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OLD SHORT HILLS RD",
            "address_2": "SUITE 216",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395604",
            "telephone_number": "973-994-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD SHORT HILLS RD",
            "address_2": "SUITE 216",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395604",
            "telephone_number": "973-994-7403",
            "fax_number": "973-994-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERSON HAGOVSKY ANTONELLI & ALTMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "973-994-7403",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "9120",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "3183",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "1880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.