Provider Demographics
NPI:1477897767
Name:RESOLUTION CONSULTANTS PSYD PC
Entity Type:Organization
Organization Name:RESOLUTION CONSULTANTS PSYD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:V
Authorized Official - Last Name:PUMILIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-325-1090
Mailing Address - Street 1:21 GARNET TERRACE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2301
Mailing Address - Country:US
Mailing Address - Phone:973-325-1090
Mailing Address - Fax:973-325-2272
Practice Address - Street 1:769 NORTHFIELD AVENUE
Practice Address - Street 2:SUITE LL6
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1198
Practice Address - Country:US
Practice Address - Phone:973-325-1090
Practice Address - Fax:973-325-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ884769Medicare UPIN