Provider Demographics
NPI:1174724389
Name:SPERBER-WEISS, DOREEN F (PHD, APRN-C)
Entity type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:F
Last Name:SPERBER-WEISS
Suffix:
Gender:F
Credentials:PHD, APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GLEN AIRLEE CT
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-2949
Mailing Address - Country:US
Mailing Address - Phone:973-455-1237
Mailing Address - Fax:973-455-1018
Practice Address - Street 1:110 REHILL AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2519
Practice Address - Country:US
Practice Address - Phone:908-685-2900
Practice Address - Fax:908-685-2956
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00100600103TC0700X
NJ26NJ0042800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2494205Medicaid
NJ2494205Medicaid