1760673198 NPI number — ADVANCED PSYCHIATRIC ASSOCIATES, LLC

Table of content: (NPI 1760673198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760673198 NPI number — ADVANCED PSYCHIATRIC ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED PSYCHIATRIC ASSOCIATES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760673198
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 HARRISTOWN RD STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN ROCK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07452-3317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-487-1240
Provider Business Mailing Address Fax Number:
201-857-3419

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 ESSEX STREET
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
HACKENSACK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07601-3245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-487-1240
Provider Business Practice Location Address Fax Number:
201-487-1241
Provider Enumeration Date:
08/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YERO
Authorized Official First Name:
SERGIO
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
973-735-4324

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com