Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | NJ164035S100164000 | NJ |
Y | 103TC0700X | Clinical Psychologist | NJ164035S100164000 | NJ |
NPI | 1285773234 |
---|---|
Provider Name | Dr. Joseph F Perzel, JR. |
First Address | Interlaken, NJ 07712-4413 |
Second Address | Neptune, NJ 07753-3902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 13/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6334806 | (05) | NJ |