Provider Demographics
NPI:1427259290
Name:MUSANTE, GERARD J (PHD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:J
Last Name:MUSANTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 PICKETT RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6005
Mailing Address - Country:US
Mailing Address - Phone:919-493-4205
Mailing Address - Fax:919-403-7244
Practice Address - Street 1:3017 PICKETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6005
Practice Address - Country:US
Practice Address - Phone:919-493-4205
Practice Address - Fax:919-403-7244
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical