Individual
GERARD VACCARELLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
248 BOULEVARD, HASBROUCK HEIGHTS, NJ 07604-1935
(201) 288-4611
(201) 288-8107
Mailing address
248 BOULEVARD, HASBROUCK HEIGHTS, NJ 07604-1935
(201) 288-4611
(201) 288-8107
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
355100234200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609106
—
NJ
01
—
7920122
AETNA PIN #
—
01
—
V4951
EMPIRE BLUE CROSS
—
Enumeration date
08/14/2006
Last updated
07/08/2007
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