Provider Demographics
NPI:1255503157
Name:GELB, SUZANNE JANE (PHD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:JANE
Last Name:GELB
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 1:1750 KALAKAUA AVE
Mailing Address - Street 2:SUITE 3203
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3766
Mailing Address - Country:US
Mailing Address - Phone:808-943-2994
Mailing Address - Fax:808-356-0549
Practice Address - Street 1:1750 KALAKAUA AVE
Practice Address - Street 2:SUITE 3203
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3766
Practice Address - Country:US
Practice Address - Phone:808-943-2994
Practice Address - Fax:808-356-0549
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY587103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI20843-9OtherHMSA
HI50619Medicare UPIN