Provider Demographics
NPI:1164559001
Name:CENTER FOR PSYCHOLOGICAL & FORENSIC SERVICES INC
Entity Type:Organization
Organization Name:CENTER FOR PSYCHOLOGICAL & FORENSIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:ISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-927-9786
Mailing Address - Street 1:538 HILLCREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657
Mailing Address - Country:US
Mailing Address - Phone:201-927-9786
Mailing Address - Fax:201-945-3179
Practice Address - Street 1:2337 LEMOINE AVENUE SUITE 201
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024
Practice Address - Country:US
Practice Address - Phone:201-927-9786
Practice Address - Fax:201-945-3179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ355100414700103TC0700X
NY015506103TC0700X
FLPY6606103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty