Provider Demographics
NPI:1962092239
Name:BAKARI, PERRY RASHIYD (LCADC)
Entity type:Individual
Prefix:MR
First Name:PERRY
Middle Name:RASHIYD
Last Name:BAKARI
Suffix:
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 EASTON AVE, PO BOX 6617
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08875-6617
Mailing Address - Country:US
Mailing Address - Phone:732-246-1347
Mailing Address - Fax:484-393-4096
Practice Address - Street 1:1080 CORNELL AVE SOUTH
Practice Address - Street 2:BUILDING 6
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002
Practice Address - Country:US
Practice Address - Phone:856-246-4744
Practice Address - Fax:973-571-8003
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37CA00165400101YA0400X
NJ37LC00364700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)