Provider Demographics
NPI:1710228382
Name:SHUMAR, SANDY PIH (LMSW, BCBA, MSED)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:PIH
Last Name:SHUMAR
Suffix:
Gender:F
Credentials:LMSW, BCBA, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 PARAMUS ROAD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-612-7800
Mailing Address - Fax:201-612-7710
Practice Address - Street 1:777 PARAMUS RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1710
Practice Address - Country:US
Practice Address - Phone:201-612-7800
Practice Address - Fax:201-612-7710
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1095583103K00000X
NJ074198104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst