Provider Demographics
NPI:1841387818
Name:DIAMENT, DEBORAH HANES (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:HANES
Last Name:DIAMENT
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 1:655 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4179
Mailing Address - Country:US
Mailing Address - Phone:732-695-1809
Mailing Address - Fax:732-933-1860
Practice Address - Street 1:655 SHREWSBURY AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4179
Practice Address - Country:US
Practice Address - Phone:732-695-1809
Practice Address - Fax:732-933-1860
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3196103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDI814747Medicare ID - Type UnspecifiedMEDICARE NUMBER