Provider Demographics
NPI:1396516977
Name:MAVIDA CARE GROUP OF NEW JERSEY PC
Entity type:Organization
Organization Name:MAVIDA CARE GROUP OF NEW JERSEY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ORECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:628-432-7476
Mailing Address - Street 1:5120 WOODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1443
Mailing Address - Country:US
Mailing Address - Phone:628-432-7476
Mailing Address - Fax:888-385-7037
Practice Address - Street 1:3600 ROUTE 66 STE 150
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-2645
Practice Address - Country:US
Practice Address - Phone:628-432-7476
Practice Address - Fax:888-385-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty