Provider Demographics
NPI:1487403812
Name:OSHER, NICOLE GLEEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:GLEEN
Last Name:OSHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BRYANT DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1232
Mailing Address - Country:US
Mailing Address - Phone:516-510-1042
Mailing Address - Fax:
Practice Address - Street 1:215 RIDGEDALE AVE STE 206
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1356
Practice Address - Country:US
Practice Address - Phone:973-200-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist