Healthcare Provider Details

I. General information

NPI: 1740119676
Provider Name (Legal Business Name): PSYCHNIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 LALOR ST
TRENTON NJ
08611-3503
US

IV. Provider business mailing address

9 LALOR ST
TRENTON NJ
08611-3503
US

V. Phone/Fax

Practice location:
  • Phone: 609-532-9965
  • Fax:
Mailing address:
  • Phone: 609-532-9965
  • Fax:

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: GEORGE KIEH
Title or Position: NURSE PRACTITIONER
Credential: APN
Phone: 609-532-9965