Healthcare Provider Details

I. General information

NPI: 1679456891
Provider Name (Legal Business Name): DOREN CHAPMAN M.S. ED.
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 MOUNTAINVIEW BLVD
WAYNE NJ
07470-6709
US

IV. Provider business mailing address

73 MOUNTAINVIEW BLVD
WAYNE NJ
07470-6709
US

V. Phone/Fax

Practice location:
  • Phone: 201-677-2693
  • Fax:
Mailing address:
  • Phone: 201-677-2693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number1244823
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number01255490
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: