MEDICARE: DR. JANICE C PUIG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	35S100299200	NJ
2	103TS0200X	School Psychologist	35S100299200	NJ

General Provider Information

NPI Number	:	1750488854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE C PUIG

Provider Business Mailing Address
First Line	:	900 KINGS HWY N
Second Line	:	SUITE 201
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1516
Country	:	US
Telephone Number	:	856-482-7755
Fax Number	:	856-779-2705

Provider Business Practice Location Address
First Line	:	900 KINGS HWY N
Second Line	:	SUITE 201
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1516
Country	:	US
Telephone Number	:	856-482-7755
Fax Number	:	856-779-2705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/11/2025

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