Healthcare Provider Details

I. General information

NPI: 1861434359
Provider Name (Legal Business Name): YVONNE E. SEDAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 KINDERKAMACK RD STE 200
RIVER EDGE NJ
07661-1916
US

IV. Provider business mailing address

516 VALLEY BROOK AVE
LYNDHURST NJ
07071-1930
US

V. Phone/Fax

Practice location:
  • Phone: 201-441-9335
  • Fax: 201-441-9711
Mailing address:
  • Phone: 201-935-3322
  • Fax: 201-460-3698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05180700
License Number StateNJ

VIII. Authorized Official

Name: YVONNE E. SEDAR
Title or Position: OUTPATIENT THERAPIST
Credential: LCSW
Phone: 201-441-9335