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General NPI Number Information
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NPI Number | 1144385147
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Entity Type | Individual
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Provider Name | JOHN JOSEPH MARCIANTE JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 505 E BROAD ST
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City | WESTFIELD
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State | NJ
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Zip | 07090-2190
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Country | US
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Telephone | 908-654-9711
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Fax |
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Provider Business Mailing Address
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Address Line | 7 DALSTON ST
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4224
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Country | US
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Telephone | 732-257-2852
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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 | 35SI00190000
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License Number State | NJ
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