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General NPI Number Information
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NPI Number | 1407210370
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Entity Type | Organization
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Legal Business Name | ROWANSOM DEPT. OF PSYCHIATRY
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 42 E LAUREL RD SUITE 2100
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City | STRATFORD
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State | NJ
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Zip | 08084-1354
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Country | US
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Telephone | 856-566-7020
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Fax | 856-566-6188
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Provider Business Mailing Address
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Address Line | 42 E LAUREL RD SUITE 2100
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City | STRATFORD
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State | NJ
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Zip | 08084-1354
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Country | US
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Telephone | 856-566-7020
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Fax | 856-566-6188
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MICHAEL RIEKER
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Credential |
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Telephone | 856-566-6994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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