Provider Demographics
NPI:1053813600
Name:CENTER FOR NETWORK THERAPY
Entity Type:Organization
Organization Name:CENTER FOR NETWORK THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CIDAMBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-560-1080
Mailing Address - Street 1:81 NORTHFIELD AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5343
Mailing Address - Country:US
Mailing Address - Phone:973-731-1375
Mailing Address - Fax:973-731-1374
Practice Address - Street 1:81 NORTHFIELD AVE STE 104
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5343
Practice Address - Country:US
Practice Address - Phone:973-731-1375
Practice Address - Fax:973-731-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000674261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder