Provider Demographics
NPI:1386986305
Name:ZMUDA, ANDREW F (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:F
Last Name:ZMUDA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 EGG HARBOR RD STE 703
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9410
Mailing Address - Country:US
Mailing Address - Phone:609-271-6582
Mailing Address - Fax:
Practice Address - Street 1:123 EGG HARBOR RD
Practice Address - Street 2:SUITE 703
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9406
Practice Address - Country:US
Practice Address - Phone:609-271-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000564106H00000X
NJ37FI00166900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist