Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 35S100217100 | NJ |
Y | 103TC0700X | Clinical Psychologist | 35S100217100 | NJ |
NPI | 1194898270 |
---|---|
Provider Name | Dr. Iris N. Biagioli |
First Address | Westfield, NJ 07090-2626 |
Second Address | Westfield, NJ 07090-2626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 16/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NJ PSYCHOLOGIST | 2171 (01) | NJ |