Provider Demographics
NPI:1477035996
Name:GENPSYCH BRICK
Entity Type:Organization
Organization Name:GENPSYCH BRICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGSAYSAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-526-8370
Mailing Address - Street 1:981 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2946
Mailing Address - Country:US
Mailing Address - Phone:908-526-8370
Mailing Address - Fax:908-801-6850
Practice Address - Street 1:940 CEDAR BRIDGE AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723
Practice Address - Country:US
Practice Address - Phone:732-475-6152
Practice Address - Fax:732-475-6172
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENPSYCH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty