Doctor Name: | MR. JEFFERY MATLIN |
NPI Number: | 1023128253 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 37PC00043300 |
Business Practice Address: | 221 Palisade Ave Jersey City, NJ - 07306 |
Business Phone Number: | 2016563116 |
Business Fax Number: | 2016569044 |
Mailing Address: | 221 Palisade Ave, JERSEY CITY |
State: | NJ |
Postal Code: | 07306 |
Phone Number: | 2016563116 |
Fax Number: | 2016569044 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 37PC00043300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |