Provider Demographics
NPI:1356469241
Name:SUBERRI, KEREN CHANSKY (PHD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:KEREN
Middle Name:CHANSKY
Last Name:SUBERRI
Suffix:
Gender:F
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7444
Mailing Address - Country:US
Mailing Address - Phone:856-770-5600
Mailing Address - Fax:
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 304
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-770-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI02914103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily