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General NPI Number Information
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NPI Number | 1629189741
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Entity Type | Organization
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Legal Business Name | ANNKLEIN FORENSIC CENTER
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 7717 STUYVESANT AVENUE
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City | WEST TRENTON
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State | NJ
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Zip | 08628
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Country | US
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Telephone | 609-292-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 325 RIDGE AVE
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City | NEWTOWN
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State | PA
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Zip | 18940-3611
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Country | US
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Telephone | 215-598-0568
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JAY COHEN
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Credential | MD
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Telephone | 609-633-0905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | 25MAO5481000
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License Number State | NJ
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