Provider Demographics
NPI:1033249537
Name:SEROY, CARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:
Last Name:SEROY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2320
Mailing Address - Country:US
Mailing Address - Phone:908-595-1333
Mailing Address - Fax:908-595-1333
Practice Address - Street 1:21 E HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2320
Practice Address - Country:US
Practice Address - Phone:908-595-1333
Practice Address - Fax:908-595-1333
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100391700103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ020625417OtherEIN