Executive Center for Psychological Medicine

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Legal business name

EXECUTIVE CENTER FOR PSYCHOLOGICAL MEDICINE

Practice address

701 White Horse Rd Ste C-101
Voorhees, NJ 08043-2494

Phone

(267) 918-9672

NPI assigned

Feb 20, 2019

Last updated

Feb 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Babatunde Adetunji, MDNPI 1326131699

Title

Psychiatrist

Phone

(267) 918-9672

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Babatunde Abayomi Adetunji, MD

  • Forensic Psychiatry Physician
  • Philadelphia, PA
  • NPI 1326131699
  NPD Authorized official

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1821555376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WHITE HORSE RD STE C-101",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432494",
            "telephone_number": "267-918-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WHITE HORSE RD STE C-101",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432494",
            "telephone_number": "267-918-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE CENTER FOR PSYCHOLOGICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "ADETUNJI",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "267-918-9672",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202266",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Psychiatry & Neurology) Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.