Provider Demographics
NPI:1528611126
Name:BRAVERMAN, ANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:BRAVERMAN
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 1:50 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3610
Mailing Address - Country:US
Mailing Address - Phone:609-558-9892
Mailing Address - Fax:
Practice Address - Street 1:166 BUNN DRIVE
Practice Address - Street 2:SUITE 107/108
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-216-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00599200103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist