Provider Demographics
NPI:1528360120
Name:IRIT FELSEN LLC
Entity Type:Organization
Organization Name:IRIT FELSEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIT
Authorized Official - Middle Name:VITA
Authorized Official - Last Name:FELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-541-9900
Mailing Address - Street 1:209 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1319
Mailing Address - Country:US
Mailing Address - Phone:973-541-9900
Mailing Address - Fax:973-541-9901
Practice Address - Street 1:420 BOULEVARD
Practice Address - Street 2:SUITE 203
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1742
Practice Address - Country:US
Practice Address - Phone:973-541-9900
Practice Address - Fax:973-541-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100375600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty