Provider Demographics
NPI:1831373034
Name:ASIMENA CHARALAMBIDIS-URBAN,PSY.D LLC
Entity type:Organization
Organization Name:ASIMENA CHARALAMBIDIS-URBAN,PSY.D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARALAMBIDIS-URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-974-4044
Mailing Address - Street 1:2130 HIGHWAY 35 # A114
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1010
Mailing Address - Country:US
Mailing Address - Phone:732-974-4044
Mailing Address - Fax:732-974-5540
Practice Address - Street 1:2130 HIGHWAY 35 # A114
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:732-974-4044
Practice Address - Fax:732-974-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2936103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty