1376075440 NPI number — BHAT PSYCHOLOGICAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376075440 NPI number — BHAT PSYCHOLOGICAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BHAT PSYCHOLOGICAL SERVICES
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:
1376075440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 EVERETT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROBBINSVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08691-4124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-991-0108
Provider Business Mailing Address Fax Number:
609-213-8732

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 EWING ST
Provider Second Line Business Practice Location Address:
SUITE A12
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-2754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-991-0108
Provider Business Practice Location Address Fax Number:
609-213-8732
Provider Enumeration Date:
03/29/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BHAT
Authorized Official First Name:
JYOTHSNA
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYD, OWNER
Authorized Official Telephone Number:
267-991-0108

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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