Organization
ELDEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA ANN PUCHAMMER MSW, LCSW (EXECUTIVE DIRECTOR)
(908) 889-0714
Entity
Organization
Contact information
Practice address
31 CARSAM ST, FANWOOD, NJ 07023-1609
(908) 889-0714
Mailing address
31 CARSAM ST, FANWOOD, NJ 07023-1609
(908) 889-0714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
44SC05307500
NJ
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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