Provider Demographics
NPI:1508466590
Name:EMPATHY INSTITUTE OF BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:EMPATHY INSTITUTE OF BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-592-3794
Mailing Address - Street 1:1044 LACEY RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1051
Mailing Address - Country:US
Mailing Address - Phone:732-592-3794
Mailing Address - Fax:732-228-8418
Practice Address - Street 1:1044 LACEY RD STE 1A
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1051
Practice Address - Country:US
Practice Address - Phone:732-592-3794
Practice Address - Fax:732-228-8418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health