Individual
DR. GERALD CELEBRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY.0003073
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COA105814
MEDICARE INDIVIDUAL PTAN
CO
Enumeration date
11/05/2007
Last updated
06/10/2021
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