Provider Demographics
NPI:1538282363
Name:CALLAGHAN, EDWARD HARVIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:HARVIE
Last Name:CALLAGHAN
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 1:96 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2919
Mailing Address - Country:US
Mailing Address - Phone:973-706-8670
Mailing Address - Fax:
Practice Address - Street 1:190 MAIN ST
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07439-1137
Practice Address - Country:US
Practice Address - Phone:973-827-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTP053-604103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical