Healthcare Provider Details

I. General information

NPI: 1942112339
Provider Name (Legal Business Name): ZACHARY WALDEN PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 ROUTE 46 STE 310
PARSIPPANY NJ
07054-1315
US

IV. Provider business mailing address

2001 ROUTE 46 STE 310
PARSIPPANY NJ
07054-1315
US

V. Phone/Fax

Practice location:
  • Phone: 516-566-0707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35SI00816100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: