Provider Demographics
NPI:1346595055
Name:ARONOV FRIED PSYCHOTHERAPY GROUP
Entity Type:Organization
Organization Name:ARONOV FRIED PSYCHOTHERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONOV
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:212-414-4480
Mailing Address - Street 1:17 MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2806
Mailing Address - Country:US
Mailing Address - Phone:973-509-9620
Mailing Address - Fax:
Practice Address - Street 1:17 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2806
Practice Address - Country:US
Practice Address - Phone:973-509-9620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ03451103TC0700X
NJ44SC050119001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty