Provider Demographics
NPI:1881256899
Name:FOGER, TANI M (EDD)
Entity type:Individual
Prefix:DR
First Name:TANI
Middle Name:M
Last Name:FOGER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:MS
Other - First Name:TANI
Other - Middle Name:M
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDM
Mailing Address - Street 1:64 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3002
Mailing Address - Country:US
Mailing Address - Phone:201-951-9243
Mailing Address - Fax:
Practice Address - Street 1:64 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3002
Practice Address - Country:US
Practice Address - Phone:201-951-9243
Practice Address - Fax:201-871-0074
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00618500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty