Healthcare Provider Details
I. General information
NPI: 1659194298
Provider Name (Legal Business Name): SPECTOR PSYCHIATRY & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2024
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
385 KINGS HWY N STE 203
CHERRY HILL NJ
08034-1013
US
IV. Provider business mailing address
385 KINGS HWY N STE 203
CHERRY HILL NJ
08034-1013
US
V. Phone/Fax
- Phone: 609-506-1498
- Fax: 609-690-2037
- Phone: 609-506-1498
- Fax: 609-690-2037
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
Z
SPECTOR
Title or Position: OWNER
Credential: APN
Phone: 609-506-1498