Healthcare Provider Details

I. General information

NPI: 1982441911
Provider Name (Legal Business Name): ROY RIM LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 ISLAND RD STE 2B
RAMSEY NJ
07446-2822
US

IV. Provider business mailing address

900 VAN HOUTEN AVE APT B4
CLIFTON NJ
07013-2721
US

V. Phone/Fax

Practice location:
  • Phone: 201-995-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FI00231000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: