Provider Demographics
NPI:1144069329
Name:MARGOLIS, ARYEH L
Entity type:Individual
Prefix:
First Name:ARYEH
Middle Name:L
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GENESEE PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1124
Mailing Address - Country:US
Mailing Address - Phone:732-664-0949
Mailing Address - Fax:
Practice Address - Street 1:545 E COUNTY LINE RD # 17A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1487
Practice Address - Country:US
Practice Address - Phone:732-664-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC005506000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health