Provider Demographics
NPI:1790196889
Name:BRAINCORE OF NORTH BERGEN
Entity Type:Organization
Organization Name:BRAINCORE OF NORTH BERGEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:T
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-662-8808
Mailing Address - Street 1:7311 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4014
Mailing Address - Country:US
Mailing Address - Phone:201-662-8808
Mailing Address - Fax:201-662-7199
Practice Address - Street 1:7311 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4014
Practice Address - Country:US
Practice Address - Phone:201-662-8808
Practice Address - Fax:201-662-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty