Provider Demographics
NPI:1801059076
Name:CENTER FOR FAMILY GUIDANCE PC
Entity type:Organization
Organization Name:CENTER FOR FAMILY GUIDANCE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MCNEECE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:856-797-4720
Mailing Address - Street 1:100 DAVIDSON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1312
Mailing Address - Country:US
Mailing Address - Phone:856-797-4720
Mailing Address - Fax:856-797-4784
Practice Address - Street 1:765 E ROUTE 70
Practice Address - Street 2:SUITE A100
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2341
Practice Address - Country:US
Practice Address - Phone:856-797-4720
Practice Address - Fax:856-797-4784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ053801Medicare PIN