Provider Demographics
NPI:1538373766
Name:LOCONTE, JOHN S (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:LOCONTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:697 VALLEY STREET
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040
Mailing Address - Country:US
Mailing Address - Phone:973-762-7162
Mailing Address - Fax:973-762-7164
Practice Address - Street 1:697 VALLEY STREET
Practice Address - Street 2:SUITE 2-A
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040
Practice Address - Country:US
Practice Address - Phone:973-762-7162
Practice Address - Fax:973-762-7164
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100359800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ009981Medicare ID - Type UnspecifiedPROVIDER NUMBER