| Doctor Name: | DR. MICHELLE SHERRI ZUCKERMAN |
| NPI Number: | 1467621169 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 4485 |
| Business Practice Address: | 505 Boulevard Kenilworth, NJ - 070331603 |
| Business Phone Number: | 9734209705 |
| Business Fax Number: | |
| Mailing Address: | 288 Main St Apt G, MADISON |
| State: | NJ |
| Postal Code: | 079402346 |
| Phone Number: | 9734209705 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2008 |
| NPI Last Update Date: | 04/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 4485 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |