Individual provider Active NPI

Milton Fuentes, PSY.D.

  • Psychologist
  • Springfield, NJ
National Provider Identifier
1992084024
Registry record updated Aug 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4095 Issued in NJ
Practice address
11 Dundar Rd
Suite 212
Springfield, NJ 07081-3553
Phone
(201) 292-4070
NPI assigned
Aug 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4095 NJ Primary

Addresses

Primary practice location

11 Dundar Rd
Suite 212
Springfield, NJ 07081-3553

Mailing address

11 Dundar Rd
Suite 212
Springfield, NJ 07081-3553
Phone (201) 292-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4095NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1312675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312675200000",
    "number": "1992084024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DUNDAR RD",
            "address_2": "SUITE 212",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070813553",
            "telephone_number": "201-292-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DUNDAR RD",
            "address_2": "SUITE 212",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070813553",
            "telephone_number": "201-292-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "MILTON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-07",
        "last_updated": "2011-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "4095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2011; 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.