Healthcare Provider Details

I. General information

NPI: 1508272204
Provider Name (Legal Business Name): NORTH JERSEY PSYCHIATRIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 ABBOTT BLVD
FORT LEE NJ
07024-4101
US

IV. Provider business mailing address

811 ABBOTT BLVD
FORT LEE NJ
07024-4101
US

V. Phone/Fax

Practice location:
  • Phone: 201-224-0127
  • Fax: 201-224-0128
Mailing address:
  • Phone: 201-224-0127
  • Fax: 201-224-0128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number25MA08915700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA08915700
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CHRISTOPHER RICHARDS
Title or Position: OWNER
Credential: MD
Phone: 201-224-0127