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General NPI Number Information
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NPI Number | 1417499260
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Entity Type | Organization
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Legal Business Name | JERSEY SHORE PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 2 MAIN ST
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City | CHATHAM
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State | NJ
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Zip | 07928-2434
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Country | US
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Telephone | 732-532-4564
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Fax | 732-303-2227
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Provider Business Mailing Address
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Address Line | 9 PROFESSIONAL CIR SUITE 202
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City | COLTS NECK
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State | NJ
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Zip | 07722-2426
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Country | US
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Telephone | 848-482-7764
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Fax | 732-303-2227
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUHAMMAD A ABBAS
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Credential | MD
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Telephone | 732-532-4564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 25MA09092000
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License Number State | NJ
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