Healthcare Provider Details

I. General information

NPI: 1255241121
Provider Name (Legal Business Name): IRENE K EREMITA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 COUNTY AVE BUILDING 6, 3RD FLOOR
SECAUCUS NJ
07094
US

IV. Provider business mailing address

595 COUNTY AVE BUILDING 6, 3RD FLOOR
SECAUCUS NJ
07094
US

V. Phone/Fax

Practice location:
  • Phone: 201-583-7111
  • Fax: 212-967-5678
Mailing address:
  • Phone: 201-583-7111
  • Fax: 212-967-5678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00977600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: