Provider Demographics
NPI:1780745638
Name:MESSER, STANLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:MESSER
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 1:324 RARITAN AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2758
Mailing Address - Country:US
Mailing Address - Phone:732-445-2323
Mailing Address - Fax:732-745-9780
Practice Address - Street 1:324 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2758
Practice Address - Country:US
Practice Address - Phone:732-445-2323
Practice Address - Fax:732-745-9780
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ920103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ19915Medicare ID - Type Unspecified