Provider Demographics
NPI:1669659587
Name:TOMLINSON, ROBERT (MDIV, MA, LP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:TOMLINSON
Suffix:
Gender:M
Credentials:MDIV, MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STONE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4196
Mailing Address - Country:US
Mailing Address - Phone:973-686-1471
Mailing Address - Fax:973-686-1471
Practice Address - Street 1:589 FRANKLIN TPKE
Practice Address - Street 2:SUITE 5
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1989
Practice Address - Country:US
Practice Address - Phone:201-444-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000799102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst