Provider Demographics
NPI:1649284571
Name:P.B.M.C., INC.
Entity type:Organization
Organization Name:P.B.M.C., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BESSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:856-848-5937
Mailing Address - Street 1:310 BRIAR HILL LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5860
Mailing Address - Country:US
Mailing Address - Phone:856-848-5937
Mailing Address - Fax:856-848-5938
Practice Address - Street 1:310 BRIAR HILL LN
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-5860
Practice Address - Country:US
Practice Address - Phone:856-848-5937
Practice Address - Fax:856-848-5938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2573103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3385507Medicaid