Provider Demographics
NPI:1043556707
Name:JANINE M TREMBLAY PHD APNC
Entity Type:Organization
Organization Name:JANINE M TREMBLAY PHD APNC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST, NP OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TREMBLAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APNC
Authorized Official - Phone:973-993-0945
Mailing Address - Street 1:150 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6099
Mailing Address - Country:US
Mailing Address - Phone:973-993-0945
Mailing Address - Fax:
Practice Address - Street 1:150 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6099
Practice Address - Country:US
Practice Address - Phone:973-993-0945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100200500103TC0700X
NJ26NJ00046800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty