Provider Demographics
NPI:1770651127
Name:REICHENBERG, PAMELA JOY (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:JOY
Last Name:REICHENBERG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 OAK LN
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2038
Mailing Address - Country:US
Mailing Address - Phone:908-272-4992
Mailing Address - Fax:908-272-0840
Practice Address - Street 1:21 EVANS PLACE
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444
Practice Address - Country:US
Practice Address - Phone:973-839-2521
Practice Address - Fax:973-839-3736
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013627001041C0700X
NYR017370-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical