NPIMap

Organization Active NPI

Psi Summit Professional Group

  • Psychiatry Physician
  • Summit, NJ
National Provider Identifier
1043404650
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSI SUMMIT PROFESSIONAL GROUP
Practice address
19 Prospect St
Summit, NJ 07901-2530
Phone
(800) 753-5223
NPI assigned
Aug 28, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PSI SUMMIT HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pat Hoffman
Title
Credentialing Agent
Phone
(800) 778-1242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

19 Prospect St
Summit, NJ 07901-2530

Mailing address

19 Prospect St
Summit, NJ 07901-2530
Phone (800) 753-5223

National Provider Directory

National Provider Directory
Tax ID family
Summit Oaks Hospital Inc3 organizations share this tax ID, including this one
Part of
Summit Oaks Hospital Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1043404650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PROSPECT ST",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012530",
            "telephone_number": "800-753-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 PROSPECT ST",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012530",
            "telephone_number": "800-753-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSI SUMMIT PROFESSIONAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSI  SUMMIT HOSPITAL INC",
        "enumeration_date": "2007-08-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "CREDENTIALING AGENT",
        "authorized_official_telephone_number": "800-778-1242"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.