Provider Demographics
NPI:1467544361
Name:TAYLOR, CLIFFORD A (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 JAMES ST
Mailing Address - Street 2:SUITE 2ER
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6392
Mailing Address - Country:US
Mailing Address - Phone:973-540-1656
Mailing Address - Fax:973-540-1889
Practice Address - Street 1:261 JAMES ST
Practice Address - Street 2:SUITE 2ER
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6392
Practice Address - Country:US
Practice Address - Phone:973-540-1656
Practice Address - Fax:973-540-1889
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NJ25MA042174002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222846600OtherTAX ID