Provider Demographics
NPI:1861571853
Name:MARGOLIN, JUDITH ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:MARGOLIN
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 1:10 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-9454
Mailing Address - Country:US
Mailing Address - Phone:609-658-2536
Mailing Address - Fax:732-329-1634
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-658-2536
Practice Address - Fax:732-329-1634
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00349300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ009233Medicare ID - Type Unspecified