Individual provider Active NPI

Gerald G Siegel, PH.D.

  • Psychologist
  • Florham Park, NJ
National Provider Identifier
1154450518
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
NJ1155 Issued in NJ
Practice address
256 Columbia Tpke Ste 102
Florham Park, NJ 07932-1231
Phone
(973) 660-0100
Fax
(973) 660-0117
NPI assigned
Mar 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NJ1155 NJ Primary

Addresses

Primary practice location

256 Columbia Tpke Ste 102
Florham Park, NJ 07932-1231

Mailing address

256 Columbia Tpke Ste 102
Florham Park, NJ 07932-1231
Phone (973) 660-0100

Other practice location 1

33 Main St
Chatham, NJ 07928-2433
Phone (973) 635-6866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
NJ1155NJMDPsychologist
1155NJMDHearing Instrument Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1154450518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 COLUMBIA TPKE STE 102",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321231",
            "telephone_number": "973-660-0100",
            "fax_number": "973-660-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 COLUMBIA TPKE STE 102",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321231",
            "telephone_number": "973-660-0100",
            "fax_number": "973-660-0117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Main St",
            "address_purpose": "LOCATION",
            "city": "Chatham",
            "state": "NJ",
            "postal_code": "079282433",
            "country_code": "US",
            "telephone_number": "973-635-6866",
            "fax_number": "973-635-8311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "GERALD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "NJ1155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.