Provider Demographics
NPI:1912178534
Name:WAINMAN, CHRISTOPHER M (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:WAINMAN
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 1:249 UNIVERSITY AVE
Mailing Address - Street 2:ROOM 101
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-1808
Mailing Address - Country:US
Mailing Address - Phone:973-353-5805
Mailing Address - Fax:
Practice Address - Street 1:249 UNIVERSITY AVE
Practice Address - Street 2:ROOM 101
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1808
Practice Address - Country:US
Practice Address - Phone:973-353-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-23
Last Update Date:2009-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJIN PROGRESS103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical