Healthcare Provider Details

I. General information

NPI: 1275233322
Provider Name (Legal Business Name): MR. MOHAMED CONTEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ADAMS LN APT 8G
NORTH BRUNSWICK NJ
08902-2574
US

IV. Provider business mailing address

500 ADAMS LN APT 8G
NORTH BRUNSWICK NJ
08902-2574
US

V. Phone/Fax

Practice location:
  • Phone: 173-266-6894
  • Fax:
Mailing address:
  • Phone: 732-666-8946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: