Provider Demographics
NPI:1982486155
Name:THERAPY WITH GI LLC
Entity type:Organization
Organization Name:THERAPY WITH GI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-328-8760
Mailing Address - Street 1:420 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2347
Mailing Address - Country:US
Mailing Address - Phone:732-328-8760
Mailing Address - Fax:
Practice Address - Street 1:16 PEARL ST STE 108
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1847
Practice Address - Country:US
Practice Address - Phone:732-328-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health