Healthcare Provider Details
I. General information
NPI: 1407772460
Provider Name (Legal Business Name): MAIN PSYCHIATRY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
271 RTE 46 W STE A208
FAIRFIELD NJ
07004-2400
US
IV. Provider business mailing address
100 HOBOKEN AVE APT 309
JERSEY CITY NJ
07310-1157
US
V. Phone/Fax
- Phone: 973-303-1054
- Fax:
- Phone: 973-303-1054
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ORRIN
PAUL
MAIN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 973-303-1054