Provider Demographics
NPI:1689959033
Name:WEST JERSEY PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:WEST JERSEY PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KURIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-684-0401
Mailing Address - Street 1:254B MOUNTAIN AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2413
Mailing Address - Country:US
Mailing Address - Phone:908-684-0401
Mailing Address - Fax:
Practice Address - Street 1:254B MOUNTAIN AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2413
Practice Address - Country:US
Practice Address - Phone:908-684-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA070618002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty