Psychiatric Associates LLP
Organization Active NPI Psychiatry Physician · Hackensack, NJ
NPI 1922019694 · NPPES record last updated Oct 26, 2007
Key facts
- NPI
- 1922019694
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- PSYCHIATRIC ASSOCIATES LLP
- Practice address
- 140 Prospect Ave
Suite 4
Hackensack, NJ 07601 - Phone
- (201) 488-6543
- Fax
- (201) 488-6916
- NPI assigned
- Aug 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Christina B Bavaro
- Title
- Billing Manager
- Phone
- (201) 488-6543
Practitioners 9
-
Joseph F Acquaviva, M.D.
-
Melissa Patrice Adessa, LCSW
-
Mark James Flood, M.D.
-
Stacey Marie Kirchner Glanz, MSW LCSW
-
Mary Beth Kneis, MSW
-
Maria Connie Malgieri, MSW, LCSW
-
Michael Christopher Molloy, MSW, LCSW
-
Matthew J Pitera, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051206000089 | NJ | Part B Supplier - Clinic/Group Practice | 9537189584 |
Receives reassigned benefits from 2 practitioners Practice locations: Rochelle Park, NJ |
National Provider Directory
Locations
140 Prospect Ave
Ste 4
Hackensack, NJ 07601
Phone (201) 488-6543
218 Route 17 N
Ste 303
Rochelle Park, NJ 07662
Phone (201) 488-6543
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
140 Prospect Ave
Suite 4
Hackensack, NJ 07601
Mailing address
140 Prospect Ave
Suite 4
Hackensack, NJ 07601
Phone (201) 488-6543
Other providers in Hackensack, NJ
- Prospect Women'S Health Center, LLC
- Prospect Women'S Medical Center
- Prospect Women'S Medical Group, P.C.
- Tracy Ann Proverbs-Singh
- Aleksandar Prvulovic
- Maksim Ptushko
- Ajay Kumar Puri
- Matthew Putts
- John Bruce Puzio
- PVP Pharmacy LLC
All providers in Hackensack, 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 Oct 26, 2007. 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.