Healthcare Provider Details

I. General information

NPI: 1992893317
Provider Name (Legal Business Name): SUMMIT PSYCHOLOGICAL SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 SUMMIT AVE SUITE 210
SUMMIT NJ
07901-3647
US

IV. Provider business mailing address

86 SUMMIT AVE SUITE 210
SUMMIT NJ
07901-3647
US

V. Phone/Fax

Practice location:
  • Phone: 908-273-5558
  • Fax: 908-273-3355
Mailing address:
  • Phone: 908-273-5558
  • Fax: 908-273-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: RONA SEEGMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 908-273-5558