Patrick T Antonelli, ED.D.

Individual provider Active NPI Marriage & Family Therapist · Livingston, NJ

NPI 1952407355 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1952407355
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
37FI00095500 (NJ)
Practice address
22 Old Short Hills Rd
Suite 216
Livingston, NJ 07039-5604
Phone
(973) 994-3145
Fax
(973) 994-9152
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
37FI00095500NJMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 37FI00095500 NJ Yes

Addresses

Primary practice location

22 Old Short Hills Rd
Suite 216
Livingston, NJ 07039-5604

Mailing address

22 Old Short Hills Rd
Suite 216
Livingston, NJ 07039-5604
Phone (973) 994-3145

Other providers in Livingston, NJ

All providers in Livingston, NJ · Marriage & Family Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.