Healthcare Provider Details

I. General information

NPI: 1992216527
Provider Name (Legal Business Name): METROPOLITAN CENTER FOR HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 10/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 DR. MARTIN LUTHER KING, JR. BOULEVARD
NEWARK NJ
07102
US

IV. Provider business mailing address

280 RIDGEWOOD BOULEVARD NORTH
TOWNSHIP OF WASHINGTON NJ
07676
US

V. Phone/Fax

Practice location:
  • Phone: 201-358-2343
  • Fax: 201-358-1008
Mailing address:
  • Phone: 201-358-2343
  • Fax: 201-358-2343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2892
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. GERARD ANTHONY FIGURELLI
Title or Position: DIRECTOR/LICENSED PSYCHOLOGIST
Credential: PH.D.
Phone: 201-358-2343