Organization
RICHARD F. FORMICA, PH.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD F FORMICA PH.D. (PRESIDENT)
(201) 384-7457
Entity
Organization
Contact information
Practice address
73 MORRIS AVE, HAWORTH, NJ 07641-1303
(201) 384-7457
Mailing address
73 MORRIS AVE, HAWORTH, NJ 07641-1303
(201) 384-7457
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35S100098200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35S100098200
NJ LICENSE #
NJ
Enumeration date
06/11/2007
Last updated
08/22/2020
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