Individual
GEORGE P GAZELLA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A
Contact information
Practice address
4040 MARKET ST, PHILADELPHIA, PA 19104-3003
(215) 895-5588
Mailing address
4040 MARKET ST STE 120, PHILADELPHIA, PA 19104-3003
(215) 895-5588
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS002708L
PA
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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