1548984511 NPI number — NEW JERSEY CENTER FOR OCD AND ANXIETY, LLC

Table of content: DR. PAUL JOSEPH JANIS OD (NPI 1952303158)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548984511 NPI number — NEW JERSEY CENTER FOR OCD AND ANXIETY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW JERSEY CENTER FOR OCD AND ANXIETY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1548984511
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
939 RIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONMOUTH JUNCTION
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08852-3200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-497-3936
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
939 RIDGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONMOUTH JUNCTION
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08852-3200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-497-3936
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BURKE
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
ANTINORO
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
609-497-3936

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)