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General NPI Number Information
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NPI Number | 1700602554
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Entity Type | Organization
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Legal Business Name | CEDARPRAG MENTAL HEALTH LLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 345 SOMERSET ST STE 102A
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City | NORTH PLAINFIELD
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State | NJ
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Zip | 07060-4774
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Country | US
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Telephone | 732-325-1839
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Fax | 908-315-9585
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Provider Business Mailing Address
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Address Line | 2079 WOODBRIDGE AVE STE 1388
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City | EDISON
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State | NJ
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Zip | 08817-4451
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Country | US
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Telephone | 732-325-1839
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Fax | 908-315-9585
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Authorized Official
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Title or Position | OWNER/APN
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Name | EBERE ANIEGBUNA
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Credential |
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Telephone | 908-531-5389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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