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General NPI Number Information
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NPI Number | 1174257323
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Entity Type | Organization
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Legal Business Name | FORT HEALTH MEDICAL GROUP OF NEW JERSEY, P.C.
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 20 ELM ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-8804
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Country | US
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Telephone | 201-208-2616
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Fax |
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Provider Business Mailing Address
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Address Line | 613 WASHINGTON BLVD # 1297
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City | JERSEY CITY
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State | NJ
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Zip | 07310-2900
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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 | PRESIDENT
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Name | SABA HAQ
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Credential | MD
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Telephone | 949-463-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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