Healthcare Provider Details

I. General information

NPI: 1629175708
Provider Name (Legal Business Name): PUIG ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/14/2020
Certification Date: 04/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 KINGS HWY N STE 311
CHERRY HILL NJ
08034-1910
US

IV. Provider business mailing address

1060 KINGS HWY N STE 311
CHERRY HILL NJ
08034-1910
US

V. Phone/Fax

Practice location:
  • Phone: 856-482-7744
  • Fax: 856-779-2705
Mailing address:
  • Phone: 856-482-7744
  • Fax: 856-779-2705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35S100180800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number35S100180800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100180800
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number35S100180800
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number35S100299200
License Number StateNJ
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100299200
License Number StateNJ

VIII. Authorized Official

Name: DR. ANGE PUIG
Title or Position: PSYCHOLOGIST
Credential: PH.D
Phone: 856-482-7744