Individual
DR. GARY R BEAUFAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1030 KINGS HWY N, SUITE 210, CHERRY HILL, NJ 08034-1907
(856) 321-1900
(856) 321-1107
Mailing address
66 MADISON AVE, PITMAN, NJ 08071-1561
(856) 256-8389
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
35SI00390700
NJ
103TC0700X
Clinical Psychologist
35SI000390700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11575043
CAQH PROVIDER ID
—
Enumeration date
01/01/2007
Last updated
09/11/2025
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