MEDOP BEHAVIORAL HEALTH ASSOCIATES OF NEW JERSEY PC

Provider Demographics

• NPI: 1982995569
• Name: MEDOP BEHAVIORAL HEALTH ASSOCIATES OF NEW JERSEY PC
• Entity Type: Organization
• Organization Name: MEDOP BEHAVIORAL HEALTH ASSOCIATES OF NEW JERSEY PC
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: DONNA
• Authorized Official - Middle Name: J
• Authorized Official - Last Name: DOOLEY
• Authorized Official - Phone: 860-370-3651
• Mailing Address - Street 1: 55 HATCHETTS HILL RD
• Mailing Address - City: OLD LYME
• Mailing Address - State: CT
• Mailing Address - Zip Code: 06371-1534
• Mailing Address - Country: US
• Mailing Address - Phone: 800-370-3651
• Mailing Address - Fax: 860-510-0020
• Practice Address - Street 1: 830 BEAR TAVERN RD
• Practice Address - City: EWING
• Practice Address - State: NJ
• Practice Address - Zip Code: 08628-1020
• Practice Address - Country: US
• Practice Address - Phone: 800-370-3651
• Practice Address - Fax: 860-510-0020
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2011-04-29
• Last Update Date: 2017-07-11

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Neurology	Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	2084P0805X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Geriatric Psychiatry	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty
No	363LG0600X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Gerontology	Group - Multi-Specialty
No	363LP0808X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Psychiatric/Mental Health	Group - Multi-Specialty
No	363LP2300X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Primary Care	Group - Multi-Specialty
No	364SA2200X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Adult Health	Group - Multi-Specialty
No	364SG0600X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Gerontology	Group - Multi-Specialty
No	364SP0808X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Psychiatric/Mental Health	Group - Multi-Specialty
No	364SP0809X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Psychiatric/Mental Health, Adult	Group - Multi-Specialty