Individual provider Active NPI

Shoval Gur-Aryeh, PH.D.

  • Clinical Psychologist
  • Teaneck, NJ
National Provider Identifier
1215335997
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5391 Issued in NJ
Practice address
165 Edgemont PL
Teaneck, NJ 07666-4620
Phone
(201) 406-9710
Fax
(201) 406-9710
NPI assigned
Dec 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021194 NY
Clinical Psychologist 103TC0700X 5391 NJ Primary

Addresses

Primary practice location

165 Edgemont PL
Teaneck, NJ 07666-4620

Mailing address

165 Edgemont PL
Teaneck, NJ 07666-4620
Phone (201) 406-9710

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5391NJMDClinical Psychologist
021194NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1215335997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 EDGEMONT PL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664620",
            "telephone_number": "201-406-9710",
            "fax_number": "201-406-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 EDGEMONT PL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664620",
            "telephone_number": "201-406-9710",
            "fax_number": "201-406-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUR-ARYEH",
        "first_name": "SHOVAL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-12",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021194",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "5391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.