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NPI Code Detail

MEDICARE: DR. MORRIS EHRENBERG PH.D.

MEDICARE: DR. MORRIS EHRENBERG PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist35SI00375500NJ

General Provider Information

NPI Number : 1023124724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MORRIS EHRENBERG PH.D.
Provider Business Mailing Address
First Line : 4 WALKAWAY LN
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08003-5137
Country : US
Telephone Number : 856-778-7560
Fax Number : 856-857-0360
Provider Business Practice Location Address
First Line : 3804 CHURCH RD
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-1106
Country : US
Telephone Number : 856-778-7560
Fax Number : 856-857-0360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 06/01/2011

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