Provider Demographics
NPI:1962811257
Name:WASSERMANN, YIFAT (PHD)
Entity type:Individual
Prefix:
First Name:YIFAT
Middle Name:
Last Name:WASSERMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ARCADIAN WAY
Mailing Address - Street 2:SUITE C2
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1291
Mailing Address - Country:US
Mailing Address - Phone:201-566-0612
Mailing Address - Fax:
Practice Address - Street 1:16 ARCADIAN WAY
Practice Address - Street 2:SUITE C2
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1291
Practice Address - Country:US
Practice Address - Phone:201-845-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100526600103TC0700X, 103TC2200X
NY020110-1103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent