Provider Demographics
NPI:1841794138
Name:WOLFF, BRAD M (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:M
Last Name:WOLFF
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 1:660 TENNENT RD STE 207
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3163
Mailing Address - Country:US
Mailing Address - Phone:732-792-0500
Mailing Address - Fax:
Practice Address - Street 1:660 TENNENT RD STE 207
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3163
Practice Address - Country:US
Practice Address - Phone:732-792-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S10014200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist