Healthcare Provider Details

I. General information

NPI: 1013606235
Provider Name (Legal Business Name): HEART MIND BODY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 SPARTA AVE STE 201
SPARTA NJ
07871-1160
US

IV. Provider business mailing address

351 SPARTA AVE STE 201
SPARTA NJ
07871-1160
US

V. Phone/Fax

Practice location:
  • Phone: 862-362-6408
  • Fax: 973-957-3222
Mailing address:
  • Phone: 862-362-6408
  • Fax: 973-957-3222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DOROTHY LEIGH GEFFKEN
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 862-362-6408