Gang, Mark Jay

Gang, Mark Jay is an sole proprietor health care provider with primary practice located at 2228 Black Rock Tpke Suite 310, Fairfield CT 06825-3237. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Gang, Mark Jay can be contacted via phone (203) 336-4264.

Contact Information

Primary practice address
2228 Black Rock Tpke Suite 310 Fairfield CT 06825-3237
Phone: (203) 336-4264
Fax: (203) 336-4265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 562 Connecticut

Profile Details

NPI number 1588684427
LBN Legal business name Gang, Mark Jay
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588684427 NPPES
Connecticut Other 173505 MANAGED HEALTH NETWORK
Connecticut Other 6129154 MANAGED HEALTH NETWORK
Connecticut Other ZS555 MANAGED HEALTH NETWORK
Connecticut Other 060000562CT04 MANAGED HEALTH NETWORK

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