Provider Demographics
NPI:1780445353
Name:ANDRISANI, FRANK (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:ANDRISANI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 VALLEY RD APT 3C
Mailing Address - Street 2:
Mailing Address - City:UPR MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-2734
Mailing Address - Country:US
Mailing Address - Phone:973-907-0774
Mailing Address - Fax:
Practice Address - Street 1:339 BLOOMFIELD AVE STE 4
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5129
Practice Address - Country:US
Practice Address - Phone:973-907-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00933300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional