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General NPI Number Information
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NPI Number | 1649284571
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Entity Type | Organization
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Legal Business Name | P.B.M.C., INC.
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 310 BRIAR HILL LN
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City | WOODBURY
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State | NJ
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Zip | 08096-5860
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Country | US
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Telephone | 856-848-5937
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Fax | 856-848-5938
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Provider Business Mailing Address
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Address Line | 310 BRIAR HILL LN
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City | WOODBURY
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State | NJ
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Zip | 08096-5860
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Country | US
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Telephone | 856-848-5937
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Fax | 856-848-5938
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JEFFREY L BESSEY
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Credential | PH.D.
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Telephone | 856-848-5937
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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 | 2573
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License Number State | NJ
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