Healthcare Provider Details

I. General information

NPI: 1568014728
Provider Name (Legal Business Name): STEP UP BEHAVIORAL CARE PC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WESTCOTT RD
DANIELSON CT
06239-2929
US

IV. Provider business mailing address

27 RANDOLPH RD
HOWELL NJ
07731-8611
US

V. Phone/Fax

Practice location:
  • Phone: 718-298-4375
  • Fax:
Mailing address:
  • Phone: 718-298-4375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: NAFTALI WEINBERGER
Title or Position: OWNER
Credential:
Phone: 718-298-4375