| Russell M. Holstein, Ph.d., Llc | |
|
170 Morris Ave Ste E Long Branch NJ 07740-8214 | |
| (732) 571-1200 | |
| (732) 571-1100 |
| Full Name | Russell M. Holstein, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 170 Morris Ave Ste E, Long Branch, New Jersey |
| Authorized Official Name and Position | Russell M. Holstein (PRESIDENT) |
| Authorized Official Contact | 7325711200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell M. Holstein, Ph.d., Llc 170 Morris Ave Ste E Long Branch NJ 07740-8214 Ph: (732) 571-1200 | Russell M. Holstein, Ph.d., Llc 170 Morris Ave Ste E Long Branch NJ 07740-8214 Ph: (732) 571-1200 |
| NPI Number | 1952453201 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952453201 | NPI | - | NPPES |
| 2392702 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 35SI00094100 (New Jersey) | Primary |
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