Doctor Name: | DR. PAUL STEVEN PORETZKY |
NPI Number: | 1528160298 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 2834 |
Business Practice Address: | 311 Beechwood Pl Leonia, NJ - 076051712 |
Business Phone Number: | 2015851409 |
Business Fax Number: | 2015857948 |
Mailing Address: | 311 Beechwood Pl, LEONIA |
State: | NJ |
Postal Code: | 076051712 |
Phone Number: | 2015851409 |
Fax Number: | 2015857948 |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 2834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |