Healthcare Provider Details

I. General information

NPI: 1831885631
Provider Name (Legal Business Name): JUMIREAN MENTAL HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9302 SUMMIT WAY
WATCHUNG NJ
07069-7403
US

IV. Provider business mailing address

9302 SUMMIT WAY
WATCHUNG NJ
07069-7403
US

V. Phone/Fax

Practice location:
  • Phone: 908-875-9243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIAN FILS
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: APN
Phone: 908-875-9243