Healthcare Provider Details

I. General information

NPI: 1053225821
Provider Name (Legal Business Name): B & B PSYCHIATRIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 TILTON RD
EGG HARBOR TOWNSHIP NJ
08234-1831
US

IV. Provider business mailing address

2600 TILTON RD
EGG HARBOR TOWNSHIP NJ
08234-1831
US

V. Phone/Fax

Practice location:
  • Phone: 609-892-9660
  • Fax:
Mailing address:
  • Phone: 609-892-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: VIVIEN A OGON
Title or Position: CREDENTIALING MANAGER
Credential: AUTHORIZED OFFICIAL
Phone: 856-398-0428