=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720906043
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIMBIC CARE NJ LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2026
-----------------------------------------------------
Last Update Date | 07/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3675 CRESTWOOD PKWY NW STE 350
-----------------------------------------------------
City | DULUTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30096-5054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-361-2574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 CHURCH ST FL 8
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10007-2614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-361-2547
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | YAVAR MOGHIMI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 912-361-2574
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------