Provider Demographics
NPI:1689706582
Name:COMERFORD, ANTHONY W (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:W
Last Name:COMERFORD
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 1:33 WILDER AVE
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6451
Mailing Address - Country:US
Mailing Address - Phone:609-419-1348
Mailing Address - Fax:
Practice Address - Street 1:80 CONOVER RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1003
Practice Address - Country:US
Practice Address - Phone:732-946-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00020000101YA0400X
NJ37PC00064600101YP2500X
NJ35S100473000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional