Provider Demographics
NPI:1588078752
Name:GAFNER, PHEBY
Entity type:Individual
Prefix:
First Name:PHEBY
Middle Name:
Last Name:GAFNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MERRITT AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1417
Mailing Address - Country:US
Mailing Address - Phone:201-398-3832
Mailing Address - Fax:
Practice Address - Street 1:250 MERRITT AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1417
Practice Address - Country:US
Practice Address - Phone:201-398-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other