Provider Demographics
NPI:1588802185
Name:BONTEMPO, ALICE M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:M
Last Name:BONTEMPO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1328
Mailing Address - Country:US
Mailing Address - Phone:201-403-6707
Mailing Address - Fax:201-444-1566
Practice Address - Street 1:71 FRANKLIN TPKE
Practice Address - Street 2:SUITE 1-3
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1851
Practice Address - Country:US
Practice Address - Phone:201-444-0090
Practice Address - Fax:201-444-1566
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00462000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist