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General NPI Number Information
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NPI Number | 1629097449
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Entity Type | Individual
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Provider Name | JAMES S. WULACH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 206 MAIN ST. SUITE 22
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City | MILLBURN
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State | NJ
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Zip | 07041-1161
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Country | US
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Telephone | 973-763-4588
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Fax |
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Provider Business Mailing Address
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Address Line | 30 PARK RD
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2216
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Country | US
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Telephone | 973-763-4588
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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 | 35 SI 00 1299 00
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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 | 005829-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35 SI 00 1299 00
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License Number State | NJ
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