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NPI Code Detail

MEDICARE: NEW JERSEY CENTER FOR OCD AND ANXIETY, LLC

MEDICARE: NEW JERSEY CENTER FOR OCD AND ANXIETY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1548984511
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW JERSEY CENTER FOR OCD AND ANXIETY, LLC
Provider Business Mailing Address
First Line : 939 RIDGE RD
Second Line :
City : MONMOUTH JUNCTION
State : NJ
Zip : 08852-3200
Country : US
Telephone Number : 609-497-3936
Fax Number :
Provider Business Practice Location Address
First Line : 939 RIDGE RD
Second Line :
City : MONMOUTH JUNCTION
State : NJ
Zip : 08852-3200
Country : US
Telephone Number : 609-497-3936
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. DIANA ANTINORO BURKE
Credential : PSYD
Telephone Number : 609-497-3936
Provider Enumeration Date : 10/03/2022
Last Update Date : 03/10/2025

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