| NPI | 1376663096 |
|---|---|
| Doing Business As | LIFESPAN |
| Entity Type | Organization |
| Authorized Contact | ROBERT B SICA Director 732-988-3441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 3SS100151900) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2014-01-21 |