MEDICARE: AMY ORIGLIERI PHD

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	103TC0700X	Clinical Psychologist	35SI00612400	NJ

General Provider Information

NPI Number	:	1841642444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ORIGLIERI PHD

Provider Business Mailing Address
First Line	:	39 BRENTWOOD DR
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-2518
Country	:	US
Telephone Number	:	212-203-3148
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 UPPER MONTCLAIR PLZ STE 27
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07043-1340
Country	:	US
Telephone Number	:	201-335-8468
Fax Number	:

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

Provider Enumeration Date	:	07/07/2016
Last Update Date	:	06/19/2024

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