Provider Demographics
NPI:1073740718
Name:REESE, ROBERT J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:REESE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 AYERS CT
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1171
Mailing Address - Country:US
Mailing Address - Phone:732-494-4516
Mailing Address - Fax:
Practice Address - Street 1:7 AYERS CT
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1171
Practice Address - Country:US
Practice Address - Phone:732-494-4516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00292500103T00000X
NY009222-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist