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General NPI Number Information
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NPI Number | 1780726638
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Entity Type | Organization
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Legal Business Name | CHATHAM PSYCHIATRIC GROUP, P.A.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 9 TULIP ST
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City | SUMMIT
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State | NJ
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Zip | 07901-2404
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Country | US
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Telephone | 908-277-7676
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Fax | 908-277-4900
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Provider Business Mailing Address
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Address Line | 9 TULIP ST
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City | SUMMIT
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State | NJ
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Zip | 07901-2404
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Country | US
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Telephone | 908-277-7676
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Fax | 908-277-4900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARIE JOHAN NOORDSIJ
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Credential | M.D.
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Telephone | 908-277-7676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 25MA1777900
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License Number State | NJ
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