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General NPI Number Information
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NPI Number | 1003427170
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Entity Type | Organization
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Legal Business Name | HADDONFIELD PSYCHIATRY, LLC
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 30 WASHINGTON AVE STE E-1
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City | HADDONFIELD
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State | NJ
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Zip | 08033-3341
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Country | US
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Telephone | 856-300-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 30 WASHINGTON AVE STE E-1
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City | HADDONFIELD
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State | NJ
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Zip | 08033-3341
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Country | US
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Telephone | 856-300-2661
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. GABRIELA M ANDRADE
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Credential | MD
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Telephone | 856-300-2661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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