Provider Demographics
NPI:1912126269
Name:YAMPOLSKY, PAUL HARRIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HARRIS
Last Name:YAMPOLSKY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SUNNYHILL RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-3729
Mailing Address - Country:US
Mailing Address - Phone:973-361-0617
Mailing Address - Fax:
Practice Address - Street 1:1247 SUSSEX TPKE STE 100
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2943
Practice Address - Country:US
Practice Address - Phone:973-895-1313
Practice Address - Fax:973-895-1383
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2194103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist