Great Moments
NPI 1396409645ActiveOrganization· Psychologist· Ridgewood, NJ
Psychologist in Ridgewood, New Jersey, registered in NPPES in October 2021. The authorized official on file is Ida Jeltova, PHD, Clinical Director.
Overview
| NPI | 1396409645 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 22, 2021 |
| Last updated in NPPES | Nov 19, 2021 |
| Certified by provider | Nov 19, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Social Worker, Clinical | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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