Healthcare Provider Details

I. General information

NPI: 1164334355
Provider Name (Legal Business Name): ELAINA VATMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALAINA VATMAN

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 BRUNSWICK WOODS DR
EAST BRUNSWICK NJ
08816-5601
US

IV. Provider business mailing address

79 E RAILROAD AVE
JAMESBURG NJ
08831-1207
US

V. Phone/Fax

Practice location:
  • Phone: 732-561-8555
  • Fax:
Mailing address:
  • Phone: 732-561-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: