DR. MARK JAY GANG (NPI# 1588684427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588684427 |
| Entity Type | Individual |
| Full Name | DR. MARK JAY GANG |
| Credential | PHD |
| Practice Address |
2228 Black Rock Tpke Suite 310 Fairfield CT 06825-3237 |
| Practice Telephone | 2033364264 |
| Practice Fax Number | 2033364265 |
| Mailing Telephone | 2033364264 |
| Mailing Fax Number | 2033364265 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 562 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BLUE CROSS | 060000562CT04 | 01 |
| CT | OXFORD | ZS555 | 01 |
| CT | MANAGED HEALTH NETWORK | 173505 | 01 |
| CT | UNITED HEALTHCARE | 6129154 | 01 |
| Street Address |
2228 BLACK ROCK TPKE SUITE 310 |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06825-3237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306840343 | Kevin Peter Mcgrath | Allergy & Immunology | 2228 Black Rock Tpke, Suite 308, Fairfield, CT 06825-3237 | 2005-06-08 |
| 1508241076 | Sophia V. Leonida, Md PC | Nurse Practitioner | 2228 Black Rock Tpke, Suite 211, Fairfield, CT 06825-3237 | 2015-07-27 |
| 1154685063 | Care of Fairfield LLC | In Home Supportive Care | 2228 Black Rock Tpke, Stillson Plaza, Suite 310, Fairfield, CT 06825-3237 | 2012-06-26 |
| 1861665184 | Hana J. Clements, M.d., LLC | Internal Medicine | 2228 Black Rock Tpke, Suite 208, Fairfield, CT 06825-3237 | 2008-04-08 |
| 1124296355 | David Garrell, M.d. LLC | Internal Medicine | 2228 Black Rock Tpke, Fairfield, CT 06825-3237 | 2008-02-11 |
| 1700821816 | Sophia V Leonida | Pediatrics | 2228 Black Rock Tpke, Suite 211, Fairfield, CT 06825-3237 | 2006-06-20 |
| 1740228410 | Ester Kirjner | Pediatrics | 2228 Black Rock Tpke, Suite 211, Fairfield, CT 06825-3237 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376535 | Andrew Kalach | Physical Therapist | 2373 Black Rock Turnpike, Fairfield, CT 06825 | 2020-08-13 |
| 1346871423 | Clarivision-advanced Eye Care | Optometrist | 40 Black Rock Turnpike, Fairfield, CT 06825 | 2020-01-28 |
| 1730720145 | L Burke LLC | Marriage & Family Therapist | 2501 Old Post Rd, 2nd Floor, Fairfield, CT 06825 | 2019-10-07 |
| 1760045066 | Stephen Miguel Pou | Dentist | 2150 Black Rock Tpke Ste 201, Fairfield, CT 06825 | 2019-04-22 |
| 1548716111 | Connecticut Orthopaedic Specialists, PC | Specialist | 425 Boston Post Road, Fairfield, CT 06825 | 2016-09-01 |
| 1497131239 | Alice Z Kelly | Social Worker | 113 Sky Top Drive, Fairfield, CT 06825 | 2015-08-04 |
| 1902218647 | John Feiler | Occupational Therapist | 175 Jefferson St., Fairfield, CT 06825 | 2014-05-29 |
| 1710242870 | Bridge Partnership, LLC | Community/Behavioral Health | 2505 Black Rock Turnpike, 2nd Floor, Fairfield, CT 06825 | 2012-07-05 |
| 1154614543 | Center for The Healing Arts, PC | Internal Medicine | 501 Kings Highway East, Suite 108, C/o Whole Body Medicine, Fairfield, CT 06825 | 2011-05-18 |
| 1538468012 | Barbara Cohen | Occupational Therapist | 175 Jefferson Street, Fairfield, CT 06825 | 2011-03-23 |
| Find all providers in zip 06825 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543695 | Dr. Mae J. Balaban & Associates LLC | Psychologist | 333 A U.S. Highway 46 W Ste 260, Fairfield, NJ 07004 | 2019-11-18 |
| 1023579265 | Jennifer Rachel Pleasure | Psychologist | 1492 Unquowa Rd, Fairfield, CT 06824-4950 | 2019-03-29 |
| 1306296454 | Neeru Madan | Psychologist | 1125 Missouri St Ste 205, Fairfield, CA 94533-6000 | 2016-06-20 |
| 1063882025 | Matthew Love | Psychologist | 140 Sherman St Fl 5, Fairfield, CT 06824-5849 | 2015-10-03 |
| 1609266014 | Janet Walker | Psychologist | 35 S Benson Cmns, Fairfield, CT 06824-6239 | 2015-01-23 |
| 1013305788 | Cheryl Lykins | Psychologist | 255 Donald Dr, Fairfield, OH 45014-3006 | 2015-01-05 |
| 1922496694 | Molly Mcneil | Psychologist | 5058 Dixie Hwy, Fairfield, OH 45014-2934 | 2015-01-05 |
| 1255766861 | Grace Kiriakos | Psychologist | 604 Empire St Fl 1, Fairfield, CA 94533-5527 | 2013-09-13 |
| 1528366689 | Michael J. Weiss | Psychologist | 333 Bennett St, Fairfield, CT 06825-1375 | 2011-03-14 |
| 1336367010 | Momentum for Mental Health - A.s.s.i.s.t. Solano Outpatient | Psychologist | 1935 Kidder Ave, Fairfield, CA 94533-3919 | 2007-04-20 |
| Find all providers in FAIRFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.