Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | S5S100538500 | NJ |
Y | 103T00000X | Psychologist | S5S100538500 | NJ |
NPI | 1003368960 |
---|---|
Provider Name | Matthew G Strobel |
First Address | Red Bank, NJ 07701-5918 |
Second Address | Red Bank, NJ 07701-5918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2016 |
Last Update Date | 26/10/2016 |