Provider Demographics
NPI:1104967660
Name:SPERLING, ARNOLD ARTHUR (EDD, APN)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:ARTHUR
Last Name:SPERLING
Suffix:
Gender:M
Credentials:EDD, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33-01 FAIR LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4324
Mailing Address - Country:US
Mailing Address - Phone:201-791-6167
Mailing Address - Fax:201-791-0256
Practice Address - Street 1:33-01 FAIR LAWN AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4324
Practice Address - Country:US
Practice Address - Phone:201-791-6167
Practice Address - Fax:201-791-0256
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1163103T00000X
NJ26NJ000222200363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0829706Medicaid
NJSP619369Medicare ID - Type Unspecified
NJR32647Medicare UPIN