Provider Demographics
NPI:1700469160
Name:TMS CLINICAL SERVICES OF NEW JERSEY LLC
Entity Type:Organization
Organization Name:TMS CLINICAL SERVICES OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RACQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAN JUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:224-777-8034
Mailing Address - Street 1:1100 JORIE BLVD STE 172
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4409
Mailing Address - Country:US
Mailing Address - Phone:224-777-8034
Mailing Address - Fax:224-236-4700
Practice Address - Street 1:161 WASHINGTON VALLEY RD STE 207
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-7177
Practice Address - Country:US
Practice Address - Phone:630-974-6602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty