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General NPI Number Information
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NPI Number | 1215281027
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Entity Type | Individual
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Provider Name | DAVID ADRIAN MCCOMBS MAXEY PHD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 168 FRONTAGE RD
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City | NEWARK
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State | NJ
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Zip | 07114-3721
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Country | US
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Telephone | 973-465-0068
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Fax |
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Provider Business Mailing Address
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Address Line | 28 MAPLE ST APT. 2
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2214
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Country | US
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Telephone | 609-356-3287
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019284
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00492200
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License Number State | NJ
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