Healthcare Provider Details

I. General information

NPI: 1396586293
Provider Name (Legal Business Name): GARMETERICK JOSEPH MOORE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 WARREN ST APT 2B
NEWARK NJ
07103-3124
US

IV. Provider business mailing address

2804 VILLAGE DR
AVENEL NJ
07001-1077
US

V. Phone/Fax

Practice location:
  • Phone: 862-900-9612
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00601800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: