Healthcare Provider Details

I. General information

NPI: 1417051103
Provider Name (Legal Business Name): MARK STEPHEN ARONSON ED.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 QUIMBY LN
BERNARDSVILLE NJ
07924-2266
US

IV. Provider business mailing address

77 OLD FORT RD
BERNARDSVILLE NJ
07924-1812
US

V. Phone/Fax

Practice location:
  • Phone: 908-953-0686
  • Fax:
Mailing address:
  • Phone: 908-953-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberSIO3223
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: