Activity and Human Performance Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

2138 Issued in NJ

Legal business name

ACTIVITY AND HUMAN PERFORMANCE CENTER

Practice address

95 Martin Luther King Jr Dr
Jersey City, NJ 07305-3025

Phone

(201) 332-7077

Fax

(201) 332-7003

NPI assigned

Oct 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark H Seglin, PH.D.NPI 1184754632

Title

President

Phone

(973) 632-0710

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark H Seglin, PH.D.

  • Psychologist
  • West Orange, NJ
  • NPI 1184754632
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1407181472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32396",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071020796",
            "telephone_number": "973-632-0710",
            "fax_number": "973-645-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MARTIN LUTHER KING JR DR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073053025",
            "telephone_number": "201-332-7077",
            "fax_number": "201-332-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVITY AND HUMAN PERFORMANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "SEGLIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-632-0710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "2138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.