Healthcare Provider Details

I. General information

NPI: 1427783992
Provider Name (Legal Business Name): ALBERT J. SULTAN, PSY.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 HIGHWAY 35 STE 205B
OAKHURST NJ
07755-2759
US

IV. Provider business mailing address

16 LADY BESS DR
DEAL NJ
07723-1015
US

V. Phone/Fax

Practice location:
  • Phone: 732-977-1958
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ALBERT JASON SULTAN
Title or Position: OWNER/NEUROPSYCHOLOGIST
Credential: PSY.D.
Phone: 732-977-1958