Healthcare Provider Details

I. General information

NPI: 1346906179
Provider Name (Legal Business Name): OPHELIA MEDICAL GROUP NJ PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 US HIGHWAY 206 BUILDING 3, SUITE #4
FLANDERS NJ
07836-9287
US

IV. Provider business mailing address

228 PARK AVE S STE 15314
NEW YORK NY
10003-1502
US

V. Phone/Fax

Practice location:
  • Phone: 215-585-2144
  • Fax: 833-228-5591
Mailing address:
  • Phone: 215-585-2144
  • Fax: 833-228-5591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARTHUR R WILLIAMS
Title or Position: CMO
Credential: MD
Phone: 347-857-8015