Healthcare Provider Details

I. General information

NPI: 1396558250
Provider Name (Legal Business Name): MICHAEL ALAN PFREMMER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WHITESVILLE RD STE A
TOMS RIVER NJ
08753-4105
US

IV. Provider business mailing address

412 E BIRD VILLAGE RD
JACKSON NJ
08527-4643
US

V. Phone/Fax

Practice location:
  • Phone: 732-504-3527
  • Fax:
Mailing address:
  • Phone: 848-482-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: