Healthcare Provider Details

I. General information

NPI: 1295599520
Provider Name (Legal Business Name): FAEMOE LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MANCHESTER AVE STE 205
FORKED RIVER NJ
08731-1367
US

IV. Provider business mailing address

34 MANCHESTER AVE STE 205
FORKED RIVER NJ
08731-1367
US

V. Phone/Fax

Practice location:
  • Phone: 732-800-7676
  • Fax: 732-800-7673
Mailing address:
  • Phone: 732-800-7676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN STEINBERG
Title or Position: PSYCHOLOGIST
Credential: PSY.D., ABPP
Phone: 732-800-7676