Provider Demographics
NPI:1073654703
Name:TARPINIAN, JOHN (EDD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:TARPINIAN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 BROADWAY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-8077
Mailing Address - Country:US
Mailing Address - Phone:201-930-1514
Mailing Address - Fax:201-930-0042
Practice Address - Street 1:172 BROADWAY
Practice Address - Street 2:SUITE 209
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-8077
Practice Address - Country:US
Practice Address - Phone:201-930-1514
Practice Address - Fax:201-930-0042
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 02119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ35-2282600Medicare UPIN
NJ444876Medicare ID - Type UnspecifiedPROVIDER NUMBER