Provider Demographics
NPI:1558920462
Name:WISHMAN, STEVEN (MSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:WISHMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1816
Mailing Address - Country:US
Mailing Address - Phone:732-598-5800
Mailing Address - Fax:
Practice Address - Street 1:10 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1816
Practice Address - Country:US
Practice Address - Phone:732-598-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00533700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker