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NPI Code Detail

MEDICARE: HOLLIS JACOBS NEMIROFF ED.S., L.P.C.

MEDICARE: HOLLIS JACOBS NEMIROFF ED.S., L.P.C.
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
1101YM0800XMental Health Counselor37PC00282500NJ
2101YM0800XMental Health CounselorPC003128PA

General Provider Information

NPI Number : 1063495885
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLIS JACOBS NEMIROFF ED.S., L.P.C.
Provider Business Mailing Address
First Line : 22 STOCKTON ST
Second Line :
City : PRINCETON
State : NJ
Zip : 08540-6813
Country : US
Telephone Number : 609-924-0060
Fax Number :
Provider Business Practice Location Address
First Line : 22 STOCKTON ST
Second Line :
City : PRINCETON
State : NJ
Zip : 08540-6813
Country : US
Telephone Number : 609-924-0060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2005
Last Update Date : 07/08/2007

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Directions to “ HOLLIS JACOBS NEMIROFF ED.S., L.P.C.” Practice Location

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