Provider Demographics
NPI:1235586595
Name:DUBLIN, DANNIS ANTHONY JR
Entity Type:Individual
Prefix:
First Name:DANNIS
Middle Name:ANTHONY
Last Name:DUBLIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HINTERSEE CT
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8617
Mailing Address - Country:US
Mailing Address - Phone:908-982-8662
Mailing Address - Fax:
Practice Address - Street 1:1000 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-2261
Practice Address - Country:US
Practice Address - Phone:908-982-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty