Provider Demographics
NPI:1750488854
Name:PUIG, JANICE C
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:C
Last Name:PUIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 KINGS HWY N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1516
Mailing Address - Country:US
Mailing Address - Phone:856-482-7755
Mailing Address - Fax:856-779-2705
Practice Address - Street 1:900 KINGS HWY N
Practice Address - Street 2:SUITE 201
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1516
Practice Address - Country:US
Practice Address - Phone:856-482-7755
Practice Address - Fax:856-779-2705
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100299200103TC0700X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool