Doctor Name: | DR. MATHIAS R HAGOVSKY |
NPI Number: | 1043315963 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 35SI00141500 |
Business Practice Address: | 22 Old Short Hills Rd Suite 216 Livingston, NJ - 070395604 |
Business Phone Number: | 9739943145 |
Business Fax Number: | 9739949152 |
Mailing Address: | 22 Old Short Hills Rd, Suite 216 LIVINGSTON |
State: | NJ |
Postal Code: | 070395604 |
Phone Number: | 9739943145 |
Fax Number: | 9739949152 |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TF0200X |
License Number: | 35SI00141500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Forensic |
Taxonomy Definition: |