Healthcare Provider Details

I. General information

NPI: 1558937409
Provider Name (Legal Business Name): ANDREW BILLUPS PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 STRATFORD PL
BOUND BROOK NJ
08805-2116
US

IV. Provider business mailing address

409 STRATFORD PL
BOUND BROOK NJ
08805-2116
US

V. Phone/Fax

Practice location:
  • Phone: 862-248-1783
  • Fax:
Mailing address:
  • Phone: 914-513-6652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number35SI00695300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: