Individual provider Active NPI

Lee Robbins Gardner, M.D.

  • Psychologist
  • Englewood, NJ
National Provider Identifier
1952412678
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
25MA02139000 Issued in NJ
Practice address
151 E Palisade Ave Apt A9
Englewood, NJ 07631-2200
Phone
(201) 394-2989
Fax
(201) 567-7947
NPI assigned
Aug 31, 2006
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 25MA02139000 NJ Primary
Psychiatry Physician 2084P0800X MA21390 NJ
Psychiatry Physician 2084P0800X 084218-1 NY
Child & Adolescent Psychiatry Physician 2084P0804X MA21390 NJ
Child & Adolescent Psychiatry Physician 2084P0804X 084218-1 NY

Addresses

Primary practice location

151 E Palisade Ave Apt A9
Englewood, NJ 07631-2200

Mailing address

151 E Palisade Ave Apt A9
Englewood, NJ 07631-2200
Phone (201) 394-2989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110609000215 NJ Practitioner - Psychiatry 1759568207 Practice locations: Englewood, NJ

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Columbia University College of Physicians and Surgeons, 1959
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

151 E Palisade Ave
Apt A9
Englewood, NJ 07631-2200
Phone (201) 394-2989

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA02139000NJMDPsychologist
MA21390NJMDPsychiatry Physician
084218-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eugene Friedberg MD LLC Psychiatry PastSince Jun 25, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1952412678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E PALISADE AVE APT A9",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312200",
            "telephone_number": "201-394-2989",
            "fax_number": "201-567-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E PALISADE AVE APT A9",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312200",
            "telephone_number": "201-394-2989",
            "fax_number": "201-567-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "LEE",
        "middle_name": "ROBBINS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "25MA02139000",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA21390",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "084218-1",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "MA21390",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "084218-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.