Provider Demographics
NPI:1871162255
Name:CARDOSO, ELIZABETH DA SILVA (PHD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DA SILVA
Last Name:CARDOSO
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 1:27 EXTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6424
Mailing Address - Country:US
Mailing Address - Phone:862-215-7968
Mailing Address - Fax:
Practice Address - Street 1:253 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2142
Practice Address - Country:US
Practice Address - Phone:973-344-1265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100445600103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling