Healthcare Provider Details

I. General information

NPI: 1063059079
Provider Name (Legal Business Name): RR & C ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 BIRCHFIELD DR
MOUNT LAUREL NJ
08054-4013
US

IV. Provider business mailing address

705 BIRCHFIELD DR
MOUNT LAUREL NJ
08054-4013
US

V. Phone/Fax

Practice location:
  • Phone: 856-359-4472
  • Fax: 856-258-0622
Mailing address:
  • Phone: 856-359-4472
  • Fax: 856-359-0622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: SUSANNA CAREW
Title or Position: CLINICAL DIRECTOR
Credential: PSY.D.
Phone: 856-296-6273