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General NPI Number Information
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NPI Number | 1003375023
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Entity Type | Organization
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Legal Business Name | CENTER FOR NETWORK THERAPY
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 20 GIBSON PL STE 103
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City | FREEHOLD
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State | NJ
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Zip | 07728-4837
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Country | US
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Telephone | 732-431-5800
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Fax | 732-431-5806
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Provider Business Mailing Address
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Address Line | 333 CEDAR AVE STE 3
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City | MIDDLESEX
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State | NJ
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Zip | 08846-2400
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Country | US
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Telephone | 732-560-1080
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KUMAR CIDAMBI
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Credential |
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Telephone | 732-560-1080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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