Healthcare Provider Details

I. General information

NPI: 1003453986
Provider Name (Legal Business Name): GENPSYCH FLEMINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 12/10/2019
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ROUTE 31 STE 104
FLEMINGTON NJ
08822-5812
US

IV. Provider business mailing address

981 US HIGHWAY 22
BRIDGEWATER NJ
08807-2946
US

V. Phone/Fax

Practice location:
  • Phone: 908-231-0511
  • Fax:
Mailing address:
  • Phone: 908-526-8370
  • Fax: 908-801-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARIANNE MAGSAYSAY
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 908-526-8370