Provider Demographics
NPI:1700542917
Name:DUMANOV, JOSEF
Entity Type:Individual
Prefix:
First Name:JOSEF
Middle Name:
Last Name:DUMANOV
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 1:181 SPRINGBROOK TRL
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2028
Mailing Address - Country:US
Mailing Address - Phone:973-726-9559
Mailing Address - Fax:
Practice Address - Street 1:181 SPRINGBROOK TRL
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2028
Practice Address - Country:US
Practice Address - Phone:973-726-9559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor