Healthcare Provider Details

I. General information

NPI: 1205594512
Provider Name (Legal Business Name): NU IMAGERY HEALTHCARELLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 RINGWOOD AVE STE 210B
HASKELL NJ
07420-1451
US

IV. Provider business mailing address

1069 RINGWOOD AVE STE 210B
HASKELL NJ
07420-1451
US

V. Phone/Fax

Practice location:
  • Phone: 201-350-7225
  • Fax:
Mailing address:
  • Phone: 201-350-7225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MELISSA SCOLLAN-KOLIOPOULOS
Title or Position: APN
Credential: EDD, DNP, PMHNP, FNP
Phone: 201-350-7225