Provider Demographics
NPI:1336260884
Name:ROSS, LLOYD (PHD)
Entity Type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5723
Mailing Address - Country:US
Mailing Address - Phone:201-967-5587
Mailing Address - Fax:201-967-5856
Practice Address - Street 1:27 N BROAD ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3801
Practice Address - Country:US
Practice Address - Phone:201-445-0280
Practice Address - Fax:201-967-5856
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100119500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist