Provider Demographics
NPI:1316446867
Name:TSIPERFAL, GARY (LCSW)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:TSIPERFAL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CHERRY HILL LN
Mailing Address - Street 2:C
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4511
Mailing Address - Country:US
Mailing Address - Phone:732-221-6581
Mailing Address - Fax:
Practice Address - Street 1:23 CHERRY HILL LN
Practice Address - Street 2:C
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-4511
Practice Address - Country:US
Practice Address - Phone:732-221-6581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty