Healthcare Provider Details

I. General information

NPI: 1134312606
Provider Name (Legal Business Name): HENRY JAMES KANDEL PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2007
Last Update Date: 08/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 E NORTHFIELD RD
LIVINGSTON NJ
07039-4503
US

IV. Provider business mailing address

900 PALISADE AVE SUITE 18D
FORT LEE NJ
07024-4135
US

V. Phone/Fax

Practice location:
  • Phone: 973-533-6999
  • Fax: 973-533-6998
Mailing address:
  • Phone: 201-699-0128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number35S100276600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: