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General NPI Number Information
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NPI Number | 1093043325
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Entity Type | Organization
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Legal Business Name | COGENT PSYCHIATRIC SERVICES
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Dates
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Enumeration Date | 11/24/2009
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 420 BOULEVARD SUITE 101
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City | MOUNTAIN LAKES
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State | NJ
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Zip | 07046-1742
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Country | US
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Telephone | 973-206-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HICKSON DR
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City | NEW PROVIDENCE
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State | NJ
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Zip | 07974-2530
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MANJULA KUMAR
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Credential | M.D.
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Telephone | 973-206-1433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA05989200
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License Number State | NJ
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