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General NPI Number Information
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NPI Number | 1811880388
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Entity Type | Organization
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Legal Business Name | EMERALD PSYCH LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 155 WILLOWBROOK BLVD STE 110-6576
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City | WAYNE
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State | NJ
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Zip | 07470-7032
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Country | US
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Telephone | 973-878-1062
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Fax |
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Provider Business Mailing Address
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Address Line | 155 WILLOWBROOK BLVD STE 1106576
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City | WAYNE
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State | NJ
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Zip | 07470-7032
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Country | US
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Telephone | 201-256-1367
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Fax | 844-998-4198
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | HELDER MENDES
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Credential |
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Telephone | 201-256-1367
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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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