Healthcare Provider Details

I. General information

NPI: 1750824892
Provider Name (Legal Business Name): REBECCA HOLCZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 RUTHERFORD BLVD
CLIFTON NJ
07014-1406
US

IV. Provider business mailing address

93 RUTHERFORD BLVD
CLIFTON NJ
07014-1406
US

V. Phone/Fax

Practice location:
  • Phone: 845-533-2761
  • Fax:
Mailing address:
  • Phone: 845-533-2761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00728900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: