First Choice Recovery Center PC
Psychologist, Addiction (Substance Use Disorder) in Ridgewood, NJ. Organization (NPI-2).
NPI number1962071910
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1962071910
- Entity type
- Organization (NPI-2)
- Legal business name
- First Choice Recovery Center PC
- Organization subpart
- No
- Enumeration date
- Jun 23, 2021
- Certification date
- Jun 22, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TA0400X | Psychologist, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
61 N Maple Ave Ste 302Ridgewood, NJ 07450-3232
Phone 201-956-9483 · Fax 201-288-5262
Mailing address
61 N Maple Ave Ste 302Ridgewood, NJ 07450-3232
Phone 201-956-9483 · Fax 201-288-5262
Authorized official
Manoj Puthiyathu
Owner
2019569483
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