Provider Demographics
NPI:1992971873
Name:CAVAIOLA, ALAN A (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:A
Last Name:CAVAIOLA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ALAN
Other - Middle Name:A
Other - Last Name:CAVAIOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3100 HWY 138 WEST
Mailing Address - Street 2:BLDG 2
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9021
Mailing Address - Country:US
Mailing Address - Phone:732-747-8480
Mailing Address - Fax:
Practice Address - Street 1:3100 STATE ROUTE 138
Practice Address - Street 2:BLDG 2 STE 2
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719-9021
Practice Address - Country:US
Practice Address - Phone:732-779-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00243400103T00000X, 103TA0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1992971873OtherNPI