Provider Demographics
NPI:1801062211
Name:RUVOLO, ANTHONY THOMAS (PHD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:THOMAS
Last Name:RUVOLO
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 1:19 SPEAR ROAD
Mailing Address - Street 2:SUITE #312
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446
Mailing Address - Country:US
Mailing Address - Phone:201-259-4037
Mailing Address - Fax:201-825-7550
Practice Address - Street 1:1000 LAKE ST STE C8
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1249
Practice Address - Country:US
Practice Address - Phone:201-259-4037
Practice Address - Fax:201-825-7550
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00064800106H00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist