Philip Louis Accaria, PH.D.
Individual provider Active NPI Clinical Psychologist · Montclair, NJ
NPI 1497879142 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497879142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 35SI00228400 (NJ)
- Practice address
- 203 Bellevue Ave
Montclair, NJ 07043-3800 - Phone
- (973) 744-3664
- Fax
- (973) 744-0430
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00228400 | NJ | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00228400 | NJ | Yes |
Addresses
Primary practice location
203 Bellevue Ave
Montclair, NJ 07043-3800
Mailing address
203 Bellevue Ave
Montclair, NJ 07043-3800
Phone (973) 744-3664
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All providers in Montclair, NJ · Clinical Psychologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.