Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MA070225 | NJ |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | MA070225 | NJ |
N | 101YM0800X | Mental Health Counselor | MA070225 | NJ |
N | 207RA0401X | Internist - Addiction Medicine | MA070225 | NJ |
NPI | 1467545079 |
---|---|
Provider Name | Dr. Abir Assaad Marcus |
First Address | Red Bank, NJ 07701-2101 |
Second Address | Red Bank, NJ 07701-2101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 17/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012068 | (05) | NJ |
H27001 | (02) | NJ |