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General NPI Number Information
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NPI Number | 1174741847
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL SOLUTIONS PC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 75 VERONICA AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-5002
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Country | US
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Telephone | 732-729-1200
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Fax | 732-729-1201
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Provider Business Mailing Address
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Address Line | 6 HAWK CT
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2275
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Country | US
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Telephone | 732-635-0209
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Fax | 732-635-0209
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DR. VIJAYA PEDDU
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Credential | M.D
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Telephone | 732-729-1200
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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 | 25MAO7619300
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License Number State | NJ
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