Provider Demographics
NPI:1144768334
Name:BLOCK, ADINA (MS)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 N 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-3632
Mailing Address - Country:US
Mailing Address - Phone:732-236-2974
Mailing Address - Fax:
Practice Address - Street 1:162 N 10TH AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-3632
Practice Address - Country:US
Practice Address - Phone:732-236-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool