Provider Demographics
NPI:1083950471
Name:GROENEWAL, PAUL HENRY (PSY D)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HENRY
Last Name:GROENEWAL
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 HARRINGTON AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-1912
Mailing Address - Country:US
Mailing Address - Phone:201-564-7331
Mailing Address - Fax:
Practice Address - Street 1:294 HARRINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-1912
Practice Address - Country:US
Practice Address - Phone:201-845-6181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100494500103TC0700X
NY019231103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical