Healthcare Provider Details

I. General information

NPI: 1558657973
Provider Name (Legal Business Name): RICHARD J HEID LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2561 YARDVILLE-HAMILTON SQUARE ROAD
HAMILTON NJ
08690
US

IV. Provider business mailing address

40 PRESTILE PLACE
ROBBINSVILLE NJ
08691-1114
US

V. Phone/Fax

Practice location:
  • Phone: 609-933-5572
  • Fax:
Mailing address:
  • Phone: 609-933-5572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number35S100404000
License Number StateNJ

VIII. Authorized Official

Name: RICHARD JAMES HEID
Title or Position: SOLE PROPRIETOR
Credential: PHD
Phone: 609-933-5572