Provider Demographics
NPI:1518178789
Name:ADLER, MIRIAM GAISIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:GAISIN
Last Name:ADLER
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 1:777 PASSAIC AVE
Mailing Address - Street 2:SUITE 565
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1804
Mailing Address - Country:US
Mailing Address - Phone:973-815-0777
Mailing Address - Fax:
Practice Address - Street 1:777 PASSAIC AVE
Practice Address - Street 2:SUITE 565
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1804
Practice Address - Country:US
Practice Address - Phone:973-815-0777
Practice Address - Fax:973-815-0737
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00443500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical