Healthcare Provider Details

I. General information

NPI: 1558363127
Provider Name (Legal Business Name): COUNTY OF UNION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WATCHUNG WAY CORNERSTONE ADMINISTRATIVE SUITE
BERKELEY HEIGHTS NJ
07922-2600
US

IV. Provider business mailing address

40 WATCHUNG WAY CORNERSTONE ADMINISTRATIVE SUITE
BERKELEY HEIGHTS NJ
07922-2600
US

V. Phone/Fax

Practice location:
  • Phone: 908-771-5705
  • Fax: 908-771-5820
Mailing address:
  • Phone: 908-771-5705
  • Fax: 908-771-5820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ERICK MESIAS
Title or Position: COUNTY COMPTROLLER
Credential:
Phone: 908-527-4754