Provider Demographics
NPI:1437673779
Name:JOEL, NOAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NOAM
Middle Name:
Last Name:JOEL
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 1:110 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4427
Mailing Address - Country:US
Mailing Address - Phone:973-777-7638
Mailing Address - Fax:
Practice Address - Street 1:25 ROBERT PITT DR STE 101B
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3366
Practice Address - Country:US
Practice Address - Phone:845-425-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022229103TC0700X
NJ35SI00717800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical