Middlesex Psychiatry & TMS PC
Organization Active NPI Psychiatry Physician · Fairfield, NJ
NPI 1053971572 · NPPES record last updated Nov 13, 2025
Key facts
- NPI
- 1053971572
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- MIDDLESEX PSYCHIATRY & TMS PC
- Practice address
- 165 Passaic Ave
Suite 200
Fairfield, NJ 07004-1580 - Phone
- (800) 413-8020
- NPI assigned
- Jun 17, 2019
- Organization subpart
- No
Authorized official
- Name
- Victoria Delisio
- Title
- Authorized Official
- Phone
- (800) 413-8020
Practitioners 107
-
Sana Ahmed, APN
-
Emily Bacon, APN-C
-
Ahniyah K Batts, LPC
-
Yvonne Serwaa Boadu, APN-BC
-
Nicole Ellen Bryan, RN, MSN, PMHNP-BC
-
Chaddy Cantona, PMHNP
-
Jovan Coleman, LAC
-
Alena Debrosse, NPP
-
Katrina Carbonell Dela Cruz, PMHNP-BC
-
Kevin C Fischer, APN
-
Olga Gonzalez-Byrne, FNP
-
Krystal L Graves, APN
-
Rafia Nicola Grooms, DNP
-
Staci Lynn Henshaw, PMHNP
-
Jacqueline Haydee Hunterton-Anderson, DNP, PMHNP-BC
-
Michael John Marco III, APRN PMHNP-BC
-
Ulanda Marcus-Aiyeku, PMHNP-BC
-
Mia Myrto McNeil, CRNP, DNP
-
Esohe Grace Obasohan, APN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NJ, PA, NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220427002709 | NJ | Part B Supplier - Clinic/Group Practice | 7315334000 |
Receives reassigned benefits from 71 practitioners Practice locations: Fairfield, NJ; Freehold, NJ; Mahwah, NJ; Marlton, NJ; Point Pleasant Boro, NJ; Voorhees, NJ |
| O20260302003345 | PA | Part B Supplier - Clinic/Group Practice | 7315334000 |
Receives reassigned benefits from 13 practitioners Practice locations: New Castle, PA |
| O20260519003727 | NY | Part B Supplier - Clinic/Group Practice | 7315334000 |
Receives reassigned benefits from 11 practitioners Practice locations: Great Neck, NY; Hauppauge, NY |
National Provider Directory
Locations
165 Passaic Ave
Ste 204
Fairfield, NJ 07004
165 Passaic Ave
Ste 200
Fairfield, NJ 07004
Phone (800) 413-8020
30 Two Bridges Rd
Ste 380
Fairfield, NJ 07004
3820 River Rd
Point Pleasant Boro, NJ 08742
Phone (732) 840-5266
11 Shenango Rd
Ste 1
New Castle, PA 16105
Phone (724) 657-1881
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
165 Passaic Ave
Suite 200
Fairfield, NJ 07004-1580
Mailing address
PO Box 80815
City of Industry, CA 91716-8420
Phone (800) 413-8020
Other practice location 1
11 Shenango Rd Ste 1
New Castle, PA 16105-1177
Phone (800) 413-8020
Other practice location 2
777 Route 70 East . G-101
Marlton, NJ 08053
Phone (800) 413-8020
Other practice location 3
330 Motor Park Way
Suite 204
Hauppauge, NY 11788
Phone (800) 413-8020
Other names
- Reservoir Health
Other providers in Fairfield, NJ
- Claudia M. Mercedes
- Eugene M Merren
- Metro DX Labs Corporation
- Michael E. Rouskas D.C. LLC
- Jonathan Mickulik
- Emily Rose Miller
- Mindful Assessments and Psychological Services, LLC
- Ming Z. Chang, M.D. P.a.
- Petko Petkov Mitev
- Mobile Sports Chiropractic, LLC
All providers in Fairfield, NJ · Psychiatry Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.