North Jersey Behavioral Medicine, LLC.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NORTH JERSEY BEHAVIORAL MEDICINE, LLC.

Practice address

2 Executive Dr
Suite 665
Fort Lee, NJ 07024-3308

Phone

(201) 669-2880

Fax

(718) 504-4122

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mona S. Ismail, M.D.

Title

Owner

Phone

(201) 669-2880

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1780803452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 RIVER RD",
            "address_2": "#8-D",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201459",
            "telephone_number": "201-669-2880",
            "fax_number": "718-504-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE DR",
            "address_2": "SUITE 665",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243308",
            "telephone_number": "201-669-2880",
            "fax_number": "718-504-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY BEHAVIORAL MEDICINE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-669-2880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.