Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2769 | NJ |
NPI | 1184655425 |
---|---|
Provider Name | Mr. Dennis H Sandrock |
First Address | South Plainfield, NJ 07080 |
Second Address | South Plainfield, NJ 07080-5300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/07/2007 |