Healthcare Provider Details

I. General information

NPI: 1598190050
Provider Name (Legal Business Name): KALMAN KHODIK PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 RIVER RD FL 1
TEANECK NJ
07666-1619
US

IV. Provider business mailing address

763 RIVER RD FL 1
TEANECK NJ
07666-1619
US

V. Phone/Fax

Practice location:
  • Phone: 888-242-2732
  • Fax: 888-242-2732
Mailing address:
  • Phone: 888-242-2732
  • Fax: 888-242-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number021116
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00554800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: