Healthcare Provider Details

I. General information

NPI: 1497365118
Provider Name (Legal Business Name): DOPPLER PSYCHOLOGY SERVICES AT HOME P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PARK AVE PH 7C
FORT LEE NJ
07024-3808
US

IV. Provider business mailing address

100 PARK AVE PH 7C
FORT LEE NJ
07024-3808
US

V. Phone/Fax

Practice location:
  • Phone: 516-810-1290
  • Fax:
Mailing address:
  • Phone: 516-810-1290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MANJU PRADHAN
Title or Position: PRESIDENT
Credential: PHD
Phone: 718-207-4088