Provider Demographics
NPI:1902829096
Name:WATTER, DANIEL NEIL (EDD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:NEIL
Last Name:WATTER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHERRY HILL RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1113
Mailing Address - Country:US
Mailing Address - Phone:973-257-9000
Mailing Address - Fax:973-257-0506
Practice Address - Street 1:50 CHERRY HILL RD
Practice Address - Street 2:SUITE 305
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1113
Practice Address - Country:US
Practice Address - Phone:973-257-9000
Practice Address - Fax:973-257-0506
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI02615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJWA599014Medicare ID - Type Unspecified