Provider Demographics
NPI:1285657320
Name:COYNE, JOSEPH J (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:COYNE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 HURLBUT ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2914
Mailing Address - Country:US
Mailing Address - Phone:201-666-6735
Mailing Address - Fax:
Practice Address - Street 1:645 WESTWOOD AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:RIVERVALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-2414
Practice Address - Country:US
Practice Address - Phone:201-666-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ627101YA0400X
NJ1930103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)