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General NPI Number Information
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NPI Number | 1104659614
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Entity Type | Organization
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Legal Business Name | TOTAL LIFE NJ P.A.
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 317 GEORGE ST STE 320
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2091
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Country | US
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Telephone | 800-567-5433
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Fax | 888-432-8212
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Provider Business Mailing Address
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Address Line | 110 FRONT ST STE 300
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City | JUPITER
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State | FL
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Zip | 33477-5095
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Country | US
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Telephone | 800-567-5433
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Fax | 888-432-8212
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | NEELKAMAL BRAR
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Credential |
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Telephone | 800-567-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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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 | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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