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General NPI Number Information
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NPI Number | 1912108192
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Entity Type | Organization
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Legal Business Name | ANXIETY & DEPRESSION TREATMENT CENTER LLC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 107 CEDAR GROVE LN STE 104
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City | SOMERSET
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State | NJ
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Zip | 08873-4719
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Country | US
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Telephone | 908-392-0869
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Fax | 763-402-7812
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Provider Business Mailing Address
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Address Line | 107 CEDAR GROVE LN STE 104
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City | SOMERSET
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State | NJ
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Zip | 08873-4719
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Country | US
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Telephone | 908-392-0869
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Fax | 763-402-7812
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DANIEL S COWEN
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Credential | M.D.
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Telephone | 908-392-0869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MAO6409800
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License Number State | NJ
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