Provider Demographics
NPI:1396558250
Name:PFREMMER, MICHAEL ALAN
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:PFREMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E BIRD VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4643
Mailing Address - Country:US
Mailing Address - Phone:848-482-6280
Mailing Address - Fax:
Practice Address - Street 1:16 WHITESVILLE RD STE A
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-4105
Practice Address - Country:US
Practice Address - Phone:732-504-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)