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General NPI Number Information
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NPI Number | 1154488658
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Entity Type | Organization
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Legal Business Name | PEAK PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5 BIRCH RUN DR
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City | PISCATAWAY
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State | NJ
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Zip | 08854-2122
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Country | US
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Telephone | 917-806-8470
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Fax | 732-907-1825
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Provider Business Mailing Address
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Address Line | 5 BIRCH RUN DR
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City | PISCATAWAY
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State | NJ
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Zip | 08854-2122
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Country | US
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Telephone | 917-806-8470
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Fax | 732-907-1825
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY W. DAYTON
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Credential | PSY.D.
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Telephone | 917-806-9470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 016654
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License Number State | NY
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