Provider Demographics
NPI:1265465322
Name:SANSONE, CARMELA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARMELA
Middle Name:
Last Name:SANSONE
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 1:32 ANDREA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4727
Mailing Address - Country:US
Mailing Address - Phone:973-227-9190
Mailing Address - Fax:973-227-3355
Practice Address - Street 1:32 ANDREA DR
Practice Address - Street 2:
Practice Address - City:NORTH CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-4727
Practice Address - Country:US
Practice Address - Phone:973-227-9190
Practice Address - Fax:973-227-3355
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ1948103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ443460Medicare ID - Type UnspecifiedPROVIDER NUMBER