Provider Demographics
NPI:1134390701
Name:AADVANTAGE PSYCHOLOGICAL CONSULTING
Entity type:Organization
Organization Name:AADVANTAGE PSYCHOLOGICAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HADASSAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GURFEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-368-3700
Mailing Address - Street 1:12 N RTE 17
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2644
Mailing Address - Country:US
Mailing Address - Phone:201-368-3700
Mailing Address - Fax:
Practice Address - Street 1:12 N RTE 17
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2644
Practice Address - Country:US
Practice Address - Phone:201-368-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1738103T00000X
NY5625103T00000X
NYF400796364SP0808X
NJ26NJ00049300364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091485Medicare PIN
NY0626G1Medicare PIN
NYV70001Medicare PIN
NJ080539Medicare PIN