Provider Demographics
NPI:1962572719
Name:MAGLIO, GESOMINA VERONICA (PHD)
Entity type:Individual
Prefix:
First Name:GESOMINA
Middle Name:VERONICA
Last Name:MAGLIO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHUKKA WAY
Mailing Address - Street 2:
Mailing Address - City:FAR HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07931-2477
Mailing Address - Country:US
Mailing Address - Phone:908-781-0864
Mailing Address - Fax:908-781-9805
Practice Address - Street 1:FAR HILLS CENTER
Practice Address - Street 2:RT 202
Practice Address - City:FAR HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07931
Practice Address - Country:US
Practice Address - Phone:908-791-0864
Practice Address - Fax:908-781-9805
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001369001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical