Active NPI
Paul Gerrish, PH.D.
- Psychologist
- Willingboro, NJ
National Provider Identifier
1790703148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1929
- Practice address
- 135 Pennypacker Dr
Willingboro, NJ 08046-2646 - Phone
- (609) 877-7423
- NPI assigned
- Jul 17, 2006
- 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 | 1929 | NJ | Primary |
Addresses
Primary practice location
135 Pennypacker Dr
Willingboro, NJ 08046-2646
Mailing address
135 Pennypacker Dr
Willingboro, NJ 08046-2646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3727203 | Medicaid | NJ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1929 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282608000000",
"number": "1790703148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 PENNYPACKER DR",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080462646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 PENNYPACKER DR",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080462646",
"telephone_number": "609-877-7423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERRISH",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2010-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "1929",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3727203",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willingboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.