Provider Demographics
NPI:1740750678
Name:GENPSYCH PC BRIDGEWATER
Entity Type:Organization
Organization Name:GENPSYCH PC BRIDGEWATER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGSAYSAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-526-8370
Mailing Address - Street 1:1065 US HIGHWAY 22 STE 3
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2949
Mailing Address - Country:US
Mailing Address - Phone:908-526-8370
Mailing Address - Fax:
Practice Address - Street 1:380 FOOTHILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2255
Practice Address - Country:US
Practice Address - Phone:908-231-0511
Practice Address - Fax:908-231-1115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENPSYCH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-04
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty