Bergen Psychological Services, LLC
Psychologist, Clinical in Fort Lee, NJ. Organization (NPI-2).
NPI number1083040232
StatusActive
Last updated in NPPESOct 16, 2015
Details
- NPI
- 1083040232
- Entity type
- Organization (NPI-2)
- Legal business name
- Bergen Psychological Services, LLC
- Organization subpart
- No
- Enumeration date
- Sep 19, 2013
- Last updated
- Oct 16, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 35SI00492800 | NJ | Yes |
Practice location
1605 John St Ste 208Fort Lee, NJ 07024-2550
Phone 973-432-7230 · Fax 201-794-4499
Mailing address
1605 John St Ste 205bFort Lee, NJ 07024-2581
Phone 973-432-7230 · Fax 201-794-4499
Authorized official
Yesenia Flores
Owner
9734327230
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