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NPI Code Detail

MEDICARE: DR. DAHLIA MANN PH.D.

MEDICARE:  DR. DAHLIA  MANN  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
1103TC0700XClinical Psychologist35S100380300NJ

General Provider Information

NPI Number : 1275740276
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAHLIA MANN PH.D.
Provider Business Mailing Address
First Line : PO BOX 772
Second Line :
City : MILLBURN
State : NJ
Zip : 07041-0772
Country : US
Telephone Number : 973-868-2431
Fax Number :
Provider Business Practice Location Address
First Line : 6B FOREST DR.
Second Line :
City : SPRINGFIELD
State : NJ
Zip : 07081-1124
Country : US
Telephone Number : 973-868-2431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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