Healthcare Provider Details

I. General information

NPI: 1609081892
Provider Name (Legal Business Name): SUSAN SOBEL ORSHAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FAR HILLS CENTER 27 ROUTE 202 SOUTH
FAR HILLS NJ
07931
US

IV. Provider business mailing address

PO BOX 616
FAR HILLS NJ
07931-0616
US

V. Phone/Fax

Practice location:
  • Phone: 908-306-0355
  • Fax:
Mailing address:
  • Phone: 908-306-0355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberSI00279100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: