| Gloria Servakh | |
|
660 Tennent Rd Ste 209 Manalapan NJ 07726-3163 | |
| (732) 351-0411 | |
| (732) 358-0811 |
| Full Name | Gloria Servakh |
|---|---|
| Speciality | Social Worker |
| Location | 660 Tennent Rd Ste 209, Manalapan, New Jersey |
| Authorized Official Name and Position | Gloria Servakh (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7323510411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloria Servakh 660 Tennent Rd Ste 209 Manalapan NJ 07726-3163 Ph: (732) 351-0411 | Gloria Servakh 660 Tennent Rd Ste 209 Manalapan NJ 07726-3163 Ph: (732) 351-0411 |
| NPI Number | 1366065740 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Medicare PECOS PAC ID | 8224459425 |
|---|---|
| Medicare Enrollment ID | O20200526001129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366065740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gloria Servakh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417455767 PECOS PAC ID: 6507106739 Enrollment ID: I20190325002354 |
| Provider Name | Frances Vender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134764236 PECOS PAC ID: 7618389537 Enrollment ID: I20201218000113 |
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