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General NPI Number Information
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NPI Number | 1093886210
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Entity Type | Individual
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Provider Name | MARSHALL STEPHEN HARTH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1172 E RIDGEWOOD AVE SUITE 4
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3936
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Country | US
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Telephone | 201-684-0942
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Fax | 201-684-0941
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Provider Business Mailing Address
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Address Line | 1172 E RIDGEWOOD AVE SUITE 4
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3936
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Country | US
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Telephone | 201-684-0942
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Fax | 201-684-0941
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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 | 35SI00436400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 005016
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License Number State | NY
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