Provider Demographics
NPI:1568998540
Name:COGNITIVE AND BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:COGNITIVE AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-918-2775
Mailing Address - Street 1:142 PALISADE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1108
Mailing Address - Country:US
Mailing Address - Phone:201-918-2775
Mailing Address - Fax:
Practice Address - Street 1:340 MERCER LOOP
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3233
Practice Address - Country:US
Practice Address - Phone:646-379-5927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09550500261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health