Provider Demographics
NPI:1427138668
Name:MERMELSTEIN, CATHERINE B (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:B
Last Name:MERMELSTEIN
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:REGENCY HERITAGE NURSING AND REHAB
Mailing Address - Street 2:380 DEMOTT LANE
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-390-9379
Mailing Address - Fax:732-390-0861
Practice Address - Street 1:REGENCY HERITAGE NURSING HOME AND REHAB
Practice Address - Street 2:380 DEMOTT LANE
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-390-9379
Practice Address - Fax:732-390-0861
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2427103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJME 616586Medicare ID - Type Unspecified