Provider Demographics
NPI:1962550228
Name:TRAMONTANO, GERALD (PHD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:TRAMONTANO
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 1:200 VALLEY RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-1320
Mailing Address - Country:US
Mailing Address - Phone:973-601-0100
Mailing Address - Fax:973-398-2211
Practice Address - Street 1:200 VALLEY RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-1320
Practice Address - Country:US
Practice Address - Phone:973-601-0100
Practice Address - Fax:973-398-2211
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ3338103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ609455Medicare PIN