Provider Demographics
NPI:1659658144
Name:MERLA-RAMOS, MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:MERLA-RAMOS
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 1:560 MAIN ST
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:LOCH ARBOUR
Mailing Address - State:NJ
Mailing Address - Zip Code:07711-1231
Mailing Address - Country:US
Mailing Address - Phone:732-775-6500
Mailing Address - Fax:732-775-6511
Practice Address - Street 1:560 MAIN ST
Practice Address - Street 2:SUITE 1G
Practice Address - City:LOCH ARBOUR
Practice Address - State:NJ
Practice Address - Zip Code:07711-1231
Practice Address - Country:US
Practice Address - Phone:732-775-6500
Practice Address - Fax:732-775-6511
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4858103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical