Provider Demographics
NPI:1154497089
Name:PRUSCINO, ANNAMARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNAMARIA
Middle Name:
Last Name:PRUSCINO
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 1:177 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747
Mailing Address - Country:US
Mailing Address - Phone:732-765-8778
Mailing Address - Fax:732-765-8768
Practice Address - Street 1:177 MAIN ST
Practice Address - Street 2:
Practice Address - City:HATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747
Practice Address - Country:US
Practice Address - Phone:732-765-8778
Practice Address - Fax:732-765-8768
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI03250103TC0700X
NY0099121103TC0700X
NJ35SI00325000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical