Provider Demographics
NPI:1457438343
Name:CAROL J DORFMAN, PH.D.
Entity Type:Organization
Organization Name:CAROL J DORFMAN, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDIENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:DORFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-569-4422
Mailing Address - Street 1:155 N DEAN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2532
Mailing Address - Country:US
Mailing Address - Phone:201-569-4422
Mailing Address - Fax:201-569-3550
Practice Address - Street 1:155 N DEAN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2532
Practice Address - Country:US
Practice Address - Phone:201-569-4422
Practice Address - Fax:201-569-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S1003949103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2357794000OtherAMERIHEALTH/KEYSTONE/ PC
297018OtherMHN
P3112491OtherOXFORD
NJS65051Medicare UPIN
P3112491OtherOXFORD