Provider Demographics
NPI:1639400633
Name:MARGENAU, ERIC A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:MARGENAU
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 1:3777 INDEPENDENCE AVE.
Mailing Address - Street 2:APT. #4H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1414
Mailing Address - Country:US
Mailing Address - Phone:646-265-4827
Mailing Address - Fax:347-964-5417
Practice Address - Street 1:68 MATTISON RD
Practice Address - Street 2:
Practice Address - City:BRANCHVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07826-4002
Practice Address - Country:US
Practice Address - Phone:646-265-4827
Practice Address - Fax:347-964-5417
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00166800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist