Alan Gettis, PH.D.
Individual provider Active NPI Clinical Psychologist · River Edge, NJ
NPI 1780760686 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780760686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1109 (NJ)
- Practice address
- 117 Kinderkamack Rd
River Edge, NJ 07661-1941 - Phone
- (201) 488-1808
- Fax
- (201) 488-3096
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
59 Pierson Ave
Norwood, NJ 07648-2428
Phone (201) 403-3097
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050630000123 | NJ | Practitioner - Clinical Psychologist | 7214973254 | Practice locations: Norwood, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1109 | NJ | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1109 | NJ | Yes |
Addresses
Primary practice location
117 Kinderkamack Rd
River Edge, NJ 07661-1941
Mailing address
117 Kinderkamack Rd
River Edge, NJ 07661-1941
Phone (201) 488-1808
Other providers in River Edge, NJ
- Robert James Gallo
- Garden State Acupuncture & Herbs PC
- Christine Louise Gares
- Loren M Gelberg-Goff
- Paula A Gencarelli
- Nanette Joan Gettis
- Caryn Gewirtzman
- Jessica Glass
- Mark S Goldfarb
- Jeffrey M Gordon
All providers in River Edge, 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.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.