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General NPI Number Information
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NPI Number | 1134080773
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Entity Type | Organization
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Legal Business Name | CREATIVE CARE PSYCHIATRY LLC
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Dates
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Enumeration Date | 11/22/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1 MARINE PLZ STE 307
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City | NORTH BERGEN
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State | NJ
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Zip | 07047-6234
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Country | US
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Telephone | 201-429-5773
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Fax | 201-425-3456
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Provider Business Mailing Address
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Address Line | 1 MARINE PLZ STE 307
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City | NORTH BERGEN
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State | NJ
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Zip | 07047-6234
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Country | US
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Telephone | 201-429-5773
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Fax | 201-425-3456
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Authorized Official
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Title or Position | OWNER
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Name | DR. BAHAR HADJIESMAEILOO
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Credential | MD
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Telephone | 703-980-5042
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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 |
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License Number State |
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