Healthcare Provider Details

I. General information

NPI: 1447968417
Provider Name (Legal Business Name): PSYCHIATRY TODAY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 BLOOMFIELD ST STE 105
HOBOKEN NJ
07030-4749
US

IV. Provider business mailing address

223 BLOOMFIELD ST STE 105
HOBOKEN NJ
07030-4749
US

V. Phone/Fax

Practice location:
  • Phone: 201-248-8822
  • Fax:
Mailing address:
  • Phone: 201-248-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JACK SURIANO
Title or Position: PART OWNER
Credential: NP
Phone: 201-248-8822