Dr. Naomi Ambalu, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

DR. NAOMI AMBALU, LLC

Practice address

115 Franklin Tpke Ste 139
Mahwah, NJ 07430-1325

Phone

(908) 998-2288

Fax

(705) 995-2043

NPI assigned

Jan 16, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Naomi Ambalu, DO

Title

Owner

Phone

(908) 998-2288

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1780192401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FRANKLIN TPKE STE 139",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301325",
            "telephone_number": "908-998-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FRANKLIN TPKE STE 139",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301325",
            "telephone_number": "908-998-2288",
            "fax_number": "705-995-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. NAOMI AMBALU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "AMBALU",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-998-2288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dolis, NP-C
• Hannah Donner, MED
• William Doran
• Brittany Doring
• Dr. D. Psychiatric Associates, PC
• Dynamic Health Partners PC
• East River Medical Associates of New Jersey PC
• Richard Craig Edelson, D.C
• Aya Elganzouri, BCBA, MA
• Andrew Eng

• Adolescent and Children Mental Health Clinic/Center in Mahwah, NJ
• Providers in Mahwah, NJ by specialty
• Adolescent and Children Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.