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General NPI Number Information
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NPI Number | 1720206246
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Entity Type | Organization
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Legal Business Name | MORRIS LAITMAN P A
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Dates
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Enumeration Date | 04/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9 ABIS PL
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1104
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Country | US
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Telephone | 732-571-3950
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Fax | 732-571-6807
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Provider Business Mailing Address
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Address Line | 9 ABIS PL
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1104
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Country | US
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Telephone | 732-571-3950
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Fax | 732-571-6807
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MORRIS LAITMAN
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Credential | PH.D
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Telephone | 732-571-3950
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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 | 35SI00011800
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License Number State | NJ
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