MEDICARE: DR. JUSTIN GARBER PSYD

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
1	103T00000X	Psychologist
2	103T00000X	Psychologist	35SI00613700	NJ

General Provider Information

NPI Number	:	1659751725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN GARBER PSYD

Provider Business Mailing Address
First Line	:	1000 LAKE ST STE 1000D
Second Line	:
City	:	RAMSEY
State	:	NJ
Zip	:	07446-1249
Country	:	US
Telephone Number	:	201-639-4032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 LAKE ST STE 1000D
Second Line	:
City	:	RAMSEY
State	:	NJ
Zip	:	07446-1249
Country	:	US
Telephone Number	:	201-639-4032
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	12/29/2022

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