Provider Demographics
NPI:1396842928
Name:NEWENHOUSE, JEFFREY M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:NEWENHOUSE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CROSSROADS PSYCHOLOGICAL ASSOCIATES
Mailing Address - Street 2:170 AVE. AT THE COMMON, SUITE 8A
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4595
Mailing Address - Country:US
Mailing Address - Phone:732-542-8043
Mailing Address - Fax:
Practice Address - Street 1:CROSSROADS PSYCHOLOGICAL ASSOCIATES
Practice Address - Street 2:170 AVE AT THE COMMON, SUITE 8A
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4595
Practice Address - Country:US
Practice Address - Phone:732-542-8043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00253900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0401501Medicaid
NJNE/738828QUCMedicare ID - Type Unspecified