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General NPI Number Information
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NPI Number | 1699274258
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Entity Type | Individual
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Provider Name | KIRSTEN BYRNES PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | AUDREY HEPBURN CHILDREN'S HOUSE, HACKENSACK UMC 12 SECOND ST
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City | HACKENSACK
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State | NJ
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Zip | 07601
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Country | US
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Telephone | 551-996-8247
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Fax |
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Provider Business Mailing Address
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Address Line | 743 HARRISON AVE APT 8
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City | HARRISON
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State | NJ
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Zip | 07029-1901
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35SI00510300
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License Number State | NJ
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