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NPI Code Detail

MEDICARE: DR. ANDREA GLEIM PSY.D.

MEDICARE: DR. ANDREA GLEIM PSY.D.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist35SI00799900NJ

General Provider Information

NPI Number : 1568928851
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA GLEIM PSY.D.
Provider Business Mailing Address
First Line : 179 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4541
Country : US
Telephone Number : 201-266-3087
Fax Number : 201-462-3916
Provider Business Practice Location Address
First Line : 179 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4541
Country : US
Telephone Number : 201-957-0103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2019
Last Update Date : 12/23/2025

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