Provider Demographics
NPI:1700369204
Name:KURLAND, JEFFREY S
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:KURLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1404
Mailing Address - Country:US
Mailing Address - Phone:201-843-5218
Mailing Address - Fax:
Practice Address - Street 1:103 HIAWATHA BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2905
Practice Address - Country:US
Practice Address - Phone:551-427-4906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00334100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty