Healthcare Provider Details

I. General information

NPI: 1144943143
Provider Name (Legal Business Name): BRIAN VEALE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3607
US

IV. Provider business mailing address

8 FERNWOOD DR
FAIR LAWN NJ
07410-3610
US

V. Phone/Fax

Practice location:
  • Phone: 201-383-6236
  • Fax:
Mailing address:
  • Phone: 551-286-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: