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General NPI Number Information
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NPI Number | 1356588719
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Entity Type | Organization
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Legal Business Name | BANYAN TREE MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 19A DELLWOOD LANE
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-247-9505
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Fax | 973-324-3641
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Provider Business Mailing Address
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Address Line | PO BOX 6776
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-6776
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Country | US
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Telephone | 732-247-9505
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Fax | 973-324-3641
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Authorized Official
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Title or Position | PRESIDENT/PSYCHOLOGIST
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Name | DR. LORAN C. VOCATURO
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Credential | EDD, ABPP
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Telephone | 732-735-3925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 35S100391200
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License Number State | NJ
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