Individual provider Active NPI

Judy Lynn Kaufman, PH.D.

  • Psychologist
  • Englewood, NJ
National Provider Identifier
1790809697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
S1001192 Issued in NJ
Practice address
163 Engle St
Building 2
Englewood, NJ 07631-2535
Phone
(201) 871-9101
Fax
(201) 541-8599
NPI assigned
Mar 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X S1001192 NJ Primary

Addresses

Primary practice location

163 Engle St
Building 2
Englewood, NJ 07631-2535

Mailing address

163 Engle St
Building 2
Englewood, NJ 07631-2535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 3, 2021 through May 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
005038NYMDMental Health Counselor
S1001192NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicola Weiss, PH.D., LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790809697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 ENGLE ST",
            "address_2": "BUILDING 2",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 ENGLE ST",
            "address_2": "BUILDING 2",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312535",
            "telephone_number": "201-871-9101",
            "fax_number": "201-541-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "S1001192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.