Provider Demographics
NPI:1124049747
Name:HARMON, MARLENE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:ANN
Last Name:HARMON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 COLUMBIA TPKE
Mailing Address - Street 2:303
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2104
Mailing Address - Country:US
Mailing Address - Phone:973-236-9160
Mailing Address - Fax:908-781-0326
Practice Address - Street 1:135 COLUMBIA TPKE
Practice Address - Street 2:303
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2104
Practice Address - Country:US
Practice Address - Phone:973-236-9160
Practice Address - Fax:908-781-0326
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00366000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ019886Medicare ID - Type Unspecified