Doctor Name: | MR. MARC WURGAFT |
NPI Number: | 1053454801 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W. |
License Number: | 44SC05283200 |
Business Practice Address: | 60 Evergreen Pl Suite 309 East Orange, NJ - 070182106 |
Business Phone Number: | 9738543652 |
Business Fax Number: | 9738543653 |
Mailing Address: | 70 Gates Ave, MONTCLAIR |
State: | NJ |
Postal Code: | 070423213 |
Phone Number: | 9736550432 |
Fax Number: | 9748543652 |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 44SC05283200 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |