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Individual

DR. GAUTAM BHASIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
185 CEDAR LN STE U6, TEANECK, NJ 07666-4303
(201) 836-3000
Mailing address
3 UNIVERSITY PLZ STE 205, HACKENSACK, NJ 07601-6208

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00627400
NJ
103TR0400X
Rehabilitation Psychologist
023210-1
NY

Other

Enumeration date
05/10/2019
Last updated
04/11/2023
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