Ellen Adamoyurka, PH.D., PSY.D.
Individual provider Active NPI Psychologist · Holmdel, NJ
NPI 1104900729 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104900729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 35S100181400 (NJ)
- Practice address
- 717 N Beers St
Holmdel, NJ 07733-1524 - Phone
- (732) 264-2440
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050624001044 | NJ | Practitioner - Clinical Psychologist | 1355386780 | Practice locations: Holmdel, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100181400 | NJ | Yes |
Addresses
Primary practice location
717 N Beers St
Holmdel, NJ 07733-1524
Mailing address
717 N Beers St
Holmdel, NJ 07733-1524
Phone (732) 264-2440
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JO 169 83 | Other | NJ | CHAMPUS |
Other providers in Holmdel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.