Provider Demographics
NPI:1457439457
Name:ERWIN, DONALD E (PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:ERWIN
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 1:620 SHREWSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4915
Mailing Address - Country:US
Mailing Address - Phone:732-530-9029
Mailing Address - Fax:732-530-0387
Practice Address - Street 1:620 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4915
Practice Address - Country:US
Practice Address - Phone:732-530-9029
Practice Address - Fax:732-530-0387
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1437103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJER553611Medicare ID - Type Unspecified