Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 35SI00626800 | NJ |
Y | 103TC0700X | Clinical Psychologist | 35SI00626800 | NJ |
NPI | 1003076241 |
---|---|
Provider Name | Alan Berlin |
First Address | Passaic, NJ 07055-2419 |
Second Address | Passaic, NJ 07055-2419 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 14/05/2020 |