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General NPI Number Information
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NPI Number | 1295950483
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Entity Type | Organization
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Legal Business Name | ABRAHAM KUPERBERG, PH.D.
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Dates
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Enumeration Date | 04/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2-31 SUMMIT AVE
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City | FAIR LAWN
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State | NJ
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Zip | 07410-2043
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Country | US
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Telephone | 845-627-1000
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Fax | 888-453-1609
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Provider Business Mailing Address
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Address Line | 55 OLD TURNPIKE RD SUITE 601
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City | NANUET
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State | NY
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Zip | 10954-2461
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Country | US
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Telephone | 845-627-1000
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Fax | 888-453-1609
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ABRAHAM KUPERBERG
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Credential | PH.D.
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Telephone | 845-627-1000
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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 | 8419
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License Number State | NY
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