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Individual

JACK P GESINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
295 WASHINGTON AVE, SUITE 5N, HAMDEN, CT 06518-3025
(203) 248-5787
Mailing address
193 OLD COACH HWY, HAMDEN, CT 06518-2024
(203) 248-5787

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
001851
CT
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001145368
CT
Enumeration date
12/21/2005
Last updated
11/14/2013
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