Doctor Name: | DR. PAUL HENRY GROENEWAL |
NPI Number: | 1083950471 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY. D. |
License Number: | 019231 |
Business Practice Address: | 24 Godwin Ave Suite 201 Midland Park, NJ - 074321927 |
Business Phone Number: | 2018456181 |
Business Fax Number: | |
Mailing Address: | 24 Godwin Ave, Suite 201 MIDLAND PARK |
State: | NJ |
Postal Code: | 074321927 |
Phone Number: | 2018456181 |
Fax Number: | |
NPI Enumeration Date: | 12/12/2012 |
NPI Last Update Date: | 12/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 019231 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |