Provider Demographics
NPI:1871776260
Name:BRAUDE KREMBERG, DINAH JOAN (PHD)
Entity type:Individual
Prefix:DR
First Name:DINAH
Middle Name:JOAN
Last Name:BRAUDE KREMBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DINAH
Other - Middle Name:JOAN
Other - Last Name:BRAUDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1215 BRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:FT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 BRIAR WAY
Practice Address - Street 2:
Practice Address - City:FT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024
Practice Address - Country:US
Practice Address - Phone:201-224-8405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100207400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist