Yedida Bomzer, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00572300 Issued in NJ

Practice address

5-02 Bryant PL
Fair Lawn, NJ 07410-2175

Phone

(732) 668-3392

NPI assigned

Oct 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Jersey Behavioral Health P.C

  • Psychologist
  • Princeton Junction, NJ
  • NPI 1538744297
  NPD

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1508333964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5-02 BRYANT PL",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102175",
            "telephone_number": "732-668-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5-02 BRYANT PL",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102175",
            "telephone_number": "732-668-3392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMZER",
        "first_name": "YEDIDA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00572300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahira Bokhari, MD
• Anthony A Bolognini
• Nicholas Bombardier, OTR
• Bomzer Psychological Associates LLC
• Philip Bomzer, PSY.D.
• Kristen Bondarenko, SLP
• Kim Boon, LMSW
• Gary S Borer, PHD
• Ariela Borgen, OTR
• Borough of Fair Lawn (Borough of Fair Lawn Ambulance Corps)

• Clinical Psychologist in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.