Gary R Beaufait, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

35SI00390700 Issued in NJ

Practice address

1030 Kings Hwy N
Suite 210
Cherry Hill, NJ 08034-1907

Phone

(856) 321-1900

Fax

(856) 321-1107

NPI assigned

Jan 1, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1952468019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 MADISON AVE",
            "city": "PITMAN",
            "state": "NJ",
            "postal_code": "080711561",
            "telephone_number": "856-256-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 KINGS HWY N",
            "address_2": "SUITE 210",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341907",
            "telephone_number": "856-321-1900",
            "fax_number": "856-321-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUFAIT",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00390700",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI000390700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11575043",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beacon Specialized Living New Jersey, Inc.
• Emily Joy Bear, PA-C
• William Brett Beard
• Jovanna Beardsworth
• Edward Kevin Beatty
• Kareltt Beccan
• Kaitlin Beck
• Scott Kenneth Becker, MPT
• Kristen Michelle Beckley
• Christy M Bedford, MOTR/L

• Clinical Neuropsychologist in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.