MEDICARE: DR. DAVID MOSHE VELDER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	35SI00238200	NJ
2	103TC0700X	Clinical Psychologist	0114371	NY
3	103TC2200X	Clinical Child & Adolescent Psychologist	35SI00238200	NJ
4	103TS0200X	School Psychologist	00120041	NJ

General Provider Information

NPI Number	:	1609989987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MOSHE VELDER PH.D.

Provider Business Mailing Address
First Line	:	28 MILLBURN AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-1039
Country	:	US
Telephone Number	:	973-258-1122
Fax Number	:	973-243-1705

Provider Business Practice Location Address
First Line	:	28 MILLBURN AVE
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-1039
Country	:	US
Telephone Number	:	973-258-1122
Fax Number	:	973-243-1705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	09/11/2025

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