Organization Name: | JOHN J. COLYAR, JR., PH.D. |
NPI Number: | 1952593212 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN JOSEPH COLYAR (OWNER/LICENSED PSYCHOLOGIST) |
Mailing Address: | 109 W Maple Ave Merchantville |
State: | NJ US |
Postal Code: | 081092038 |
Phone Number: | 8566610324 |
Fax Number: | |
NPI Enumeration Date: | 08/10/2007 |
NPI Last Update Date: | 09/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | SI02758 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |