Provider Demographics
NPI:1376083840
Name:SHARI BURSZTYN PHD- PSYCH SERVICES
Entity Type:Organization
Organization Name:SHARI BURSZTYN PHD- PSYCH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURSZTYN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-204-5007
Mailing Address - Street 1:1366 DICKERSON RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2816
Mailing Address - Country:US
Mailing Address - Phone:917-204-5007
Mailing Address - Fax:
Practice Address - Street 1:304 S VAN DIEN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-5200
Practice Address - Country:US
Practice Address - Phone:917-204-5007
Practice Address - Fax:201-445-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S1004511001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health