Provider Demographics
NPI:1902379001
Name:ESSEX PSYCHIATRIC AND RECOVERY PC
Entity Type:Organization
Organization Name:ESSEX PSYCHIATRIC AND RECOVERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-795-1260
Mailing Address - Street 1:101 EISENHOWER PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1054
Mailing Address - Country:US
Mailing Address - Phone:973-795-1260
Mailing Address - Fax:973-795-1259
Practice Address - Street 1:101 EISENHOWER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1054
Practice Address - Country:US
Practice Address - Phone:973-795-1260
Practice Address - Fax:973-795-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder