Individual
PHILIP BOMZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
5-02 BRYANT PL, FAIR LAWN, NJ 07410-2175
(917) 374-3074
Mailing address
5-02 BRYANT PL, FAIR LAWN, NJ 07410-2175
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
020582
NY
103TC0700X
Clinical Psychologist
Primary
35SI00543800
NJ
103TM1800X
Intellectual & Developmental Disabilities Psychologist
020582
NY
Other
Enumeration date
06/22/2009
Last updated
10/26/2020
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