Provider Demographics
NPI:1194898270
Name:BIAGIOLI, IRIS N (PH,D)
Entity type:Individual
Prefix:DR
First Name:IRIS
Middle Name:N
Last Name:BIAGIOLI
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 TICE PL
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2626
Mailing Address - Country:US
Mailing Address - Phone:908-654-6868
Mailing Address - Fax:908-654-8043
Practice Address - Street 1:865 TICE PL
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2626
Practice Address - Country:US
Practice Address - Phone:908-654-6868
Practice Address - Fax:908-654-8043
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 103TB0200X
NJ35S100217100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNJ PSYCHOLOGISTOther2171
NJNJ PSYCHOLOGISTOther2171