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General NPI Number Information
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NPI Number | 1083768469
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Entity Type | Individual
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Provider Name | ELAINE C TERRY GARROD PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 38 ROSELAND AVENUE
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City | ROSELAND
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State | NJ
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Zip | 07068
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Country | US
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Telephone | 973-618-0088
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Fax | 973-364-8032
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Provider Business Mailing Address
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Address Line | 59 SCHINDLER WAY
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City | FAIRFIELD
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State | NJ
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Zip | 07004
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Country | US
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Telephone | 973-364-8030
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Fax | 973-364-8032
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35S100329000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 012314 1
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License Number State | NY
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