Provider Demographics
NPI:1285773234
Name:PERZEL,, JOSEPH F JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:PERZEL,
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:F
Other - Last Name:PERZEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:316 BRIDLEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:INTERLAKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4413
Mailing Address - Country:US
Mailing Address - Phone:908-675-0198
Mailing Address - Fax:732-663-1543
Practice Address - Street 1:333 OLD CORLIES AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3902
Practice Address - Country:US
Practice Address - Phone:908-675-0198
Practice Address - Fax:732-663-1543
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0400X
NJNJ164035S100164000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6334806Medicaid