Healthcare Provider Details

I. General information

NPI: 1922813138
Provider Name (Legal Business Name): FREDERICK SCOTT STARR, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SUMMIT AVE STE 202
HACKENSACK NJ
07601-0007
US

IV. Provider business mailing address

5 SUMMIT AVE STE 202
HACKENSACK NJ
07601-1271
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-3427
  • Fax: 973-909-8157
Mailing address:
  • Phone: 908-340-6197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: FREDERICK STARR
Title or Position: OWNER
Credential: MD
Phone: 201-449-2913