Provider Demographics
NPI:1033928510
Name:DREITLEIN, RAYMOND (PHD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:DREITLEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SHERMAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1171
Mailing Address - Country:US
Mailing Address - Phone:908-464-4751
Mailing Address - Fax:
Practice Address - Street 1:230 SHERMAN AVE STE A
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1171
Practice Address - Country:US
Practice Address - Phone:908-464-4751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00021700103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)