Richard F. Formica, PH.D., P.a.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35S100098200 Issued in NJ

Legal business name

RICHARD F. FORMICA, PH.D., P.A.

Practice address

73 Morris Ave
Haworth, NJ 07641-1303

Phone

(201) 384-7457

NPI assigned

Jun 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard F Formica, PH.D.

Title

President

Phone

(201) 384-7457

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447454863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 MORRIS AVE",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411303",
            "telephone_number": "201-384-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 MORRIS AVE",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411303",
            "telephone_number": "201-384-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD F. FORMICA, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORMICA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-384-7457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100098200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE #",
            "identifier": "35S100098200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.