Provider Demographics
NPI:1184171464
Name:ELLEN M HERR-ISRAEL PH D LLC
Entity type:Organization
Organization Name:ELLEN M HERR-ISRAEL PH D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERR-ISRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-625-1534
Mailing Address - Street 1:166 BUNN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2800
Mailing Address - Country:US
Mailing Address - Phone:908-625-1534
Mailing Address - Fax:
Practice Address - Street 1:166 BUNN DR STE 102
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2800
Practice Address - Country:US
Practice Address - Phone:908-625-1534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-05
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00563100103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty