Individual
JASON GUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2201 HEMPSTEAD TPKE, NASSAU UNIVERSITY MEDICAL CENTER, EAST MEADOW, NY 11554-1859
(516) 572-9373
Mailing address
28 HANOVER PL, MERRICK, NY 11566-2631
(516) 729-9742
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
015504
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015504
LICENSE NUMBER
NY
Enumeration date
11/13/2006
Last updated
07/08/2007
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