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General NPI Number Information
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NPI Number | 1124885645
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Entity Type | Individual
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Provider Name | MARINA FOORD APN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 03/02/2024
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Provider Practice Location Address
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Address Line | 777 BLOOMFIELD AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1242
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Country | US
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Telephone | 973-594-0125
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Fax |
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Provider Business Mailing Address
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Address Line | 777 BLOOMFIELD AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1242
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Country | US
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Telephone | 973-594-0125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 26NJ14868400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 26NJ14868400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 26NJ14868400
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 26NJ14868400
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License Number State | NJ
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