| Richard Gaines, Ph.d., Llc | |
|
88 W Ridgewood Ave Ridgewood NJ 07450-3199 | |
| (201) 444-9866 | |
| Not Available |
| Full Name | Richard Gaines, Ph.d., Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 88 W Ridgewood Ave, Ridgewood, New Jersey |
| Authorized Official Name and Position | Richard William Gaines (OWNER) |
| Authorized Official Contact | 2014449866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Gaines, Ph.d., Llc 140 Deer Trl N Ramsey NJ 07446-2113 Ph: (201) 314-0515 | Richard Gaines, Ph.d., Llc 88 W Ridgewood Ave Ridgewood NJ 07450-3199 Ph: (201) 444-9866 |
| NPI Number | 1235497744 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 06/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235497744 | NPI | - | NPPES |
| 061718 | Other | NJ | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3956 (New Jersey) | Primary |
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