Provider Demographics
NPI:1548308091
Name:CIERI, ELIZABETH ANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:CIERI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 COOPER AVENUE
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1850
Mailing Address - Country:US
Mailing Address - Phone:973-509-0090
Mailing Address - Fax:973-744-4993
Practice Address - Street 1:209 COOPER AVENUE
Practice Address - Street 2:SUITE 10A
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1850
Practice Address - Country:US
Practice Address - Phone:973-509-0090
Practice Address - Fax:973-744-4993
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3775103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037117Medicare ID - Type Unspecified