Provider Demographics
NPI:1093946642
Name:SHIFRIN, JOSHUA GREGORY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:GREGORY
Last Name:SHIFRIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7417
Mailing Address - Country:US
Mailing Address - Phone:860-966-0309
Mailing Address - Fax:
Practice Address - Street 1:26 LINDEN AVE
Practice Address - Street 2:NEUROPSYCHOLOGICAL TESTING CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1834
Practice Address - Country:US
Practice Address - Phone:860-966-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEV061OtherAGENCY MEDICARE ID #
NY1285628552OtherAGENCY NPI #
NY00355940OtherAGENCY MEDICAID PROVIDER ID