Individual provider Active NPI

Margery Blau Manheim, PH.D

  • Psychologist
  • Metuchen, NJ
National Provider Identifier
1578616173
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3024 Issued in NJ
Practice address
467 Middlesex Ave
Metuchen, NJ 08840-1460
Phone
(732) 906-6628
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3024 NJ Primary

Addresses

Primary practice location

467 Middlesex Ave
Metuchen, NJ 08840-1460

Mailing address

304 East Chestnut Ave
Metuchen, NJ 08840-1517
Phone (732) 494-0814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3024NJMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578616173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 EAST CHESTNUT AVE",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401517",
            "telephone_number": "732-494-0814",
            "fax_number": "732-494-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 MIDDLESEX AVE",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401460",
            "telephone_number": "732-906-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANHEIM",
        "first_name": "MARGERY",
        "middle_name": "BLAU",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.