Provider Demographics
NPI:1932450731
Name:RESOLUTION CONSULTANT, PC
Entity Type:Organization
Organization Name:RESOLUTION CONSULTANT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:V
Authorized Official - Last Name:PUMILIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-325-1090
Mailing Address - Street 1:769 NORTHFIELD AVE STE LL6
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1106
Mailing Address - Country:US
Mailing Address - Phone:973-325-1090
Mailing Address - Fax:973-325-2272
Practice Address - Street 1:769 NORTHFIELD AVE STE LL6
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1106
Practice Address - Country:US
Practice Address - Phone:973-325-1090
Practice Address - Fax:973-325-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI3400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPU884765Medicare PIN