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535 Lacey Rd Suite 6 Forked River NJ 08731-1533 | |
(609) 693-7903 | |
Not Available |
Full Name | |
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Speciality | Psychologist |
Location | 535 Lacey Rd, Forked River, New Jersey |
Authorized Official Name and Position | Glenn R. Candeletti (PRESIDENT) |
Authorized Official Contact | 6096937903 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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535 Lacey Rd Suite 6 Forked River NJ 08731-1533 Ph: (609) 693-7903 | 535 Lacey Rd Suite 6 Forked River NJ 08731-1533 Ph: (609) 693-7903 |
NPI Number | 1134210222 |
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Provider Enumeration Date | 09/27/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1134210222 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | 35SI00202900 (New Jersey) | Primary |
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