Provider Demographics
NPI:1083827521
Name:MARGANOFF, PHYLLIS P (EDD)
Entity type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:P
Last Name:MARGANOFF
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 ANN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5105
Mailing Address - Country:US
Mailing Address - Phone:908-359-1969
Mailing Address - Fax:908-359-1943
Practice Address - Street 1:205 ANN ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5105
Practice Address - Country:US
Practice Address - Phone:908-359-1969
Practice Address - Fax:908-359-1943
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00140400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist