Provider Demographics
NPI:1083017958
Name:HOWARD HAMMER, PSY. D., PA
Entity Type:Organization
Organization Name:HOWARD HAMMER, PSY. D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D, PA
Authorized Official - Phone:856-691-1511
Mailing Address - Street 1:1138 E CHESTNUT AVE STE 6B
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5053
Mailing Address - Country:US
Mailing Address - Phone:856-691-1511
Mailing Address - Fax:856-691-8511
Practice Address - Street 1:1138 E CHESTNUT AVE STE 6B
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5053
Practice Address - Country:US
Practice Address - Phone:856-691-1511
Practice Address - Fax:856-691-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1678103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ443153Medicare UPIN