Provider Demographics
NPI:1366835225
Name:INTEGRATED THERAPEUTIC SERVICES PC
Entity Type:Organization
Organization Name:INTEGRATED THERAPEUTIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CEFARATTI-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-377-3373
Mailing Address - Street 1:445 CENTRAL AVE
Mailing Address - Street 2:345
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2001
Mailing Address - Country:US
Mailing Address - Phone:718-534-0689
Mailing Address - Fax:
Practice Address - Street 1:17 RYAN RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2941
Practice Address - Country:US
Practice Address - Phone:718-534-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty