Healthcare Provider Details

I. General information

NPI: 1013939032
Provider Name (Legal Business Name): GEORGE JOSEPH CARNEVALE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CLIFTON AVE
CLIFTON NJ
07013-3600
US

IV. Provider business mailing address

2 GIRARD PL
MAPLEWOOD NJ
07040-3108
US

V. Phone/Fax

Practice location:
  • Phone: 973-773-8820
  • Fax: 972-472-3143
Mailing address:
  • Phone: 973-761-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35SI00255300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00255300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number35SI00255300
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number35SI00255300
License Number StateNJ
# 5
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number35SI00255300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: