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General NPI Number Information
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NPI Number | 1003370693
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Entity Type | Individual
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Provider Name | ELLEN HERR-ISRAEL
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Gender | Female
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 166 BUNN DR
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City | PRINCETON
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State | NJ
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Zip | 08540-2800
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Country | US
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Telephone | 908-625-1534
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Fax |
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Provider Business Mailing Address
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Address Line | 14 FIELDSTONE RD
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City | SKILLMAN
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State | NJ
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Zip | 08558-1639
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Country | US
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Telephone | 908-625-1534
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35S100563100
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License Number State | NJ
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