Provider Demographics
NPI:1831468263
Name:NORTH JERSEY PSYCHIATRY,INC
Entity Type:Organization
Organization Name:NORTH JERSEY PSYCHIATRY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-861-0077
Mailing Address - Street 1:31 W RUBY AVE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1008
Mailing Address - Country:US
Mailing Address - Phone:201-861-0077
Mailing Address - Fax:201-861-9595
Practice Address - Street 1:5912 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2112
Practice Address - Country:US
Practice Address - Phone:201-861-0077
Practice Address - Fax:201-861-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA71572305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8428409Medicaid
NJF18896Medicare UPIN
NJ8428409Medicaid