Great Moments

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

GREAT MOMENTS

Practice address

88 W Ridgewood Ave
Ridgewood, NJ 07450-3199

Phone

(201) 757-0600

Fax

(800) 507-2456

NPI assigned

Oct 22, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ida Jeltova, PHD

Title

Clinical Director

Phone

(201) 757-0600

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1396409645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 W RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503199",
            "telephone_number": "201-757-0600",
            "fax_number": "800-507-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 W RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503199",
            "telephone_number": "201-757-0600",
            "fax_number": "800-507-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT MOMENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "JELTOVA",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "201-757-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine N. Goulet, APN
• Patrick Bryan Granelli, LCSW
• Grant N Ko MD
• Juan B Grau, M.D.
• Julie M Grayson
• Greatest Moments Counseling, Inc
• Biljana Grebinnik
• Judith Green, LCSW
• Barton H Greenberg, LCSW
• William Michael Greenberg, M.D.

• Psychologist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.