Healthcare Provider Details

I. General information

NPI: 1063765808
Provider Name (Legal Business Name): YELENA GOLDIN FRAZIER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YELENA GOLDIN PH.D.

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 SCHOOLEYS MOUNTAIN RD
HACKETTSTOWN NJ
07840-4000
US

IV. Provider business mailing address

118 HOPE RD
GREAT MEADOWS NJ
07838-2404
US

V. Phone/Fax

Practice location:
  • Phone: 347-200-2337
  • Fax:
Mailing address:
  • Phone: 347-200-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number019165
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35SI00501500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: