Provider Demographics
NPI:1588790125
Name:KUPFERMAN, ROSLYN P (MA)
Entity type:Individual
Prefix:MS
First Name:ROSLYN
Middle Name:P
Last Name:KUPFERMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 WINTHROP RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3043
Mailing Address - Country:US
Mailing Address - Phone:201-837-6381
Mailing Address - Fax:
Practice Address - Street 1:304 WINTHROP RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3043
Practice Address - Country:US
Practice Address - Phone:201-837-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJFL000639103T00000X
NY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist