Healthcare Provider Details

I. General information

NPI: 1700986189
Provider Name (Legal Business Name): ASSOCIATES IN PSYCHIATRY OF NORTH JERSEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 NORTHFIELD AVE SUITE 204
WEST ORANGE NJ
07052-3026
US

IV. Provider business mailing address

PO BOX 389
SUMMIT NJ
07902-0389
US

V. Phone/Fax

Practice location:
  • Phone: 973-325-6120
  • Fax: 973-325-6126
Mailing address:
  • Phone: 908-922-7247
  • Fax: 908-222-0841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NIRMAL SATHAYE
Title or Position: PARTNER
Credential: MD
Phone: 908-922-7247