Provider Demographics
NPI:1386269116
Name:CULLEN, MAURA E (PSYD)
Entity type:Individual
Prefix:DR
First Name:MAURA
Middle Name:E
Last Name:CULLEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2421
Mailing Address - Country:US
Mailing Address - Phone:646-460-0036
Mailing Address - Fax:
Practice Address - Street 1:5 MOUNTAIN BLVD STE 4
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2625
Practice Address - Country:US
Practice Address - Phone:908-757-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist