Provider Demographics
NPI:1538319413
Name:STURMAN, MARIANNE (PHD)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:STURMAN
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 1:111 HOWARD BLV
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856
Mailing Address - Country:US
Mailing Address - Phone:973-223-7079
Mailing Address - Fax:973-398-2211
Practice Address - Street 1:111 HOWARD BLV
Practice Address - Street 2:SUITE 204
Practice Address - City:MT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856
Practice Address - Country:US
Practice Address - Phone:973-223-7079
Practice Address - Fax:973-398-2211
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100299500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ057918Medicare PIN
NJP58783Medicare UPIN