DENISE WALLACK


Address: 470 Forest St, Unit 2, Kearny, NJ 07032-3582
Phone: 9737157593

DENISE WALLACK (NPI# 1326401969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326401969
Entity Type Individual
Full Name DENISE WALLACK
Credential PSY.D.
Practice Address 470 Forest St
Unit 2
Kearny
NJ 07032-3582
Practice Telephone 9737157593
Mailing Telephone 9737157593
Enumeration Date 2016-03-31
Last Update Date 2016-03-31
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TB0200X Psychologist
Specialization: Cognitive & Behavioral
35SI00558100 NJ Behavioral Health & Social Service Providers

Office Location

Street Address 470 FOREST ST
UNIT 2
City KEARNY
State NJ
Zip Code 07032-3582

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1467750836 Anita Hillary Pharmacist 248 Kearny Avenue, Kearny, NJ 07032 2011-03-08
1770818486 Twyla N Rentas Nurse Practitioner 30 Hackensack Ave., Kearny, NJ 07032 2009-10-14
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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

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1639614308 Lauren Michelle Foran Psychologist 3575 Quakerbridge Road, Hamilton, NJ 08619 2017-01-04
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1831582170 Anton Shcherbakov Psychologist 1910 Route 70 E Ste 5&7, Cherry Hill, NJ 08003-2123 2015-03-11
1962742189 Therapeutic Outreach for Children, Inc Psychologist 1 Farm Ln # 458, Roosevelt, NJ 08555-9800 2013-02-25
1235496332 Sandra Singer Psychologist 7 S Main St Ste B, Marlboro, NJ 07746-1578 2012-04-13
1891922738 Alana Miriam Balaban Fisher Psychologist 764 Palisade Ave Ste 1f, Teaneck, NJ 07666-3129 2009-06-18
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Competitor

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City KEARNY
Zip Code 07032

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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