Provider Demographics
NPI:1568577336
Name:PREMINGER, MICHELE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LYNN
Last Name:PREMINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 FRANKLIN TPKE
Mailing Address - Street 2:SUITE 2-6
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1851
Mailing Address - Country:US
Mailing Address - Phone:201-820-2980
Mailing Address - Fax:201-820-1016
Practice Address - Street 1:71 FRANKLIN TPKE
Practice Address - Street 2:SUITE 2-6
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1851
Practice Address - Country:US
Practice Address - Phone:201-820-2980
Practice Address - Fax:201-820-1016
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA073958002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry