Provider Demographics
NPI:1659478741
Name:PUIG, ANGE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGE
Middle Name:
Last Name:PUIG
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 1:1060 KINGS HWY N STE 311
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1910
Mailing Address - Country:US
Mailing Address - Phone:856-482-7744
Mailing Address - Fax:856-779-2705
Practice Address - Street 1:1060 KINGS HWY N STE 311
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1910
Practice Address - Country:US
Practice Address - Phone:856-482-7744
Practice Address - Fax:856-779-2705
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100180800101YA0400X, 103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling