Provider Demographics
NPI:1255674503
Name:TMS CENTERS OF SOUTHERN NEW JERSEY
Entity Type:Organization
Organization Name:TMS CENTERS OF SOUTHERN NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:BARUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-273-8000
Mailing Address - Street 1:813 E GATE DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1238
Mailing Address - Country:US
Mailing Address - Phone:856-273-8000
Mailing Address - Fax:856-273-6408
Practice Address - Street 1:813 E GATE DR
Practice Address - Street 2:SUITE D
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1238
Practice Address - Country:US
Practice Address - Phone:856-273-8000
Practice Address - Fax:856-273-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA059056002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty