1558851592 NPI number — HELLENIC PSYCHOLOGY CENTER

Table of content: JONATHAN FRANK WEISBECKER RPH (NPI 1295178267)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558851592 NPI number — HELLENIC PSYCHOLOGY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELLENIC PSYCHOLOGY CENTER
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:
6
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:
1558851592
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
914 TICE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07090-2629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-451-2016
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
567 PARK AVE STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTCH PLAINS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07076-1754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-322-0112
Provider Business Practice Location Address Fax Number:
908-789-0230
Provider Enumeration Date:
05/15/2018

Additional Information

Authorized Official

Authorized Official Last Name:
DI IORIO
Authorized Official First Name:
EMILIO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
908-451-2016

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  1083787774 , 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)

  • Identifier: 1083787774 . This is a "PRIVATE PRACTICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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