Provider Demographics
NPI:1780892166
Name:ERNST, WILLIAM JOHN (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:ERNST
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:495 IRON BRIDGE RD STE 8
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5306
Mailing Address - Country:US
Mailing Address - Phone:215-262-0741
Mailing Address - Fax:609-424-3164
Practice Address - Street 1:495 IRON BRIDGE RD STE 8
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5306
Practice Address - Country:US
Practice Address - Phone:215-262-0741
Practice Address - Fax:609-424-3164
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00409100103G00000X
PAPS015223103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist