Active NPI
Larry W Gingold, PSY.D.
- Clinical Psychologist
- Teaneck, NJ
National Provider Identifier
1487794368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2254
- Practice address
- 101 Cedar LN
Suite 202
Teaneck, NJ 07666-4417 - Phone
- (201) 836-9430
- Fax
- (201) 385-0652
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2254 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 7760 | NY |
Addresses
Primary practice location
101 Cedar LN
Suite 202
Teaneck, NJ 07666-4417
Mailing address
101 Cedar LN
Suite 202
Teaneck, NJ 07666-4417
Phone (201) 836-9430
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2254 | NJ | MD | Clinical Psychologist |
| 7760 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487794368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CEDAR LN",
"address_2": "SUITE 202",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664417",
"telephone_number": "201-836-9430",
"fax_number": "201-385-0652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CEDAR LN",
"address_2": "SUITE 202",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664417",
"telephone_number": "201-836-9430",
"fax_number": "201-385-0652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GINGOLD",
"first_name": "LARRY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "2254",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "7760",
"primary": false
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.