Provider Demographics
NPI:1972352383
Name:MITTELMAN, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:MITTELMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 LINDEGAR ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4027
Mailing Address - Country:US
Mailing Address - Phone:347-746-3297
Mailing Address - Fax:
Practice Address - Street 1:806 LINDEGAR ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4027
Practice Address - Country:US
Practice Address - Phone:347-746-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health