Provider Demographics
NPI:1801099809
Name:DON DIGIOVINE, PH.D. LLC
Entity type:Organization
Organization Name:DON DIGIOVINE, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGIOVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-891-7334
Mailing Address - Street 1:886 BELMONT AVE
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2573
Mailing Address - Country:US
Mailing Address - Phone:973-423-3983
Mailing Address - Fax:201-891-7334
Practice Address - Street 1:886 BELMONT AVE
Practice Address - Street 2:SUITE # 3
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2573
Practice Address - Country:US
Practice Address - Phone:973-423-3983
Practice Address - Fax:201-891-7334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00271000103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1194878264OtherINDIVIDUAL