MEDICARE: DR. RICHARD FEDERICI LLC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	35SI00170900	NJ
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist	35SI00170900	NJ
3	103TA0700X	Adult Development & Aging Psychologist	35SI00170900	NJ
4	103TB0200X	Cognitive & Behavioral Psychologist	35SI00170900	NJ
5	103TC2200X	Clinical Child & Adolescent Psychologist	35SI00170900	NJ
6	103TE1100X	Exercise & Sports Psychologist	35SI00170900	NJ
7	103TF0000X	Family Psychologist	35SI00170900	NJ
8	103TF0200X	Forensic Psychologist	35SI00170900	NJ
9	103TP2701X	Group Psychotherapy Psychologist	35SI00170900	NJ
10	103TR0400X	Rehabilitation Psychologist	35SI00170900	NJ
11	103TC0700X	Clinical Psychologist	35SI00170900	NJ

NPI Number	:	1063577112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. RICHARD FEDERICI LLC

Provider Business Mailing Address
First Line	:	10 ANDERSON HILL RD
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2323
Country	:	US
Telephone Number	:	973-533-1208
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 ANDERSON HILL RD
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2323
Country	:	US
Telephone Number	:	973-533-1208
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	RICHARD FEDERICI
Credential	:	PH.D.
Telephone Number	:	973-533-1208

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	05/10/2022

10 ANDERSON RD
BERNARDSVILLE, NJ
07924-2323

Practice Phone: 908-221-1410
Practice Fax: 908-221-9304