Provider Demographics
NPI:1124376827
Name:ROBERT CHORNEY PSYD AT NEW ROADS LLC
Entity Type:Organization
Organization Name:ROBERT CHORNEY PSYD AT NEW ROADS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHORNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-926-1165
Mailing Address - Street 1:2106 NEW RD
Mailing Address - Street 2:SUITE F3
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1046
Mailing Address - Country:US
Mailing Address - Phone:609-926-1165
Mailing Address - Fax:609-926-1228
Practice Address - Street 1:2106 NEW RD
Practice Address - Street 2:SUITE F3
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1046
Practice Address - Country:US
Practice Address - Phone:609-926-1165
Practice Address - Fax:609-926-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00267300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
644926Medicare PIN
R31694Medicare UPIN