Healthcare Provider Details

I. General information

NPI: 1740178680
Provider Name (Legal Business Name): JONATHAN EPSTEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S LENOLA RD
MAPLE SHADE NJ
08052-1630
US

IV. Provider business mailing address

17 SYLVAN ST STE 207
RUTHERFORD NJ
07070-2037
US

V. Phone/Fax

Practice location:
  • Phone: 856-221-4914
  • Fax:
Mailing address:
  • Phone: 973-446-5591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FA00007100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: