UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC
Clinical Neuropsychologist
Newark, New Jersey
Provider NPI: 1598775199
Organization Information:Organization Name: UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC
Organization is Subpart
Authorized Official: DAVID HAIER CEO/EXECUTIVE DIRECTOR 973-9729503
Practice Location:
185 S ORANGE AVE NEWARK, NJ 07103 US
Tel: 973-972-2977 Fax: --
Business Mailing Address:
30 BERGEN ST ADMC 121205 NEWARK, NJ 07107 US
Tel: 973-972-0037 Fax: 973-972-9355
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is Subpart
Authorized Official: DAVID HAIER CEO/EXECUTIVE DIRECTOR 973-9729503
Practice Location:
185 S ORANGE AVE NEWARK, NJ 07103 US
Tel: 973-972-2977 Fax: --
Business Mailing Address:
30 BERGEN ST ADMC 121205 NEWARK, NJ 07107 US
Tel: 973-972-0037 Fax: 973-972-9355
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | ||
Y | 103T00000X | Behavioral Health & Social Service Providers Psychologist | ||
N | 2084P0800X | Physicians Psychiatry & Neurology | ||
N | 2084P0804X | Physicians Psychiatry & Neurology |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
2814731 | NJ | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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