Psychiatry Services

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

26NJ00099700 Issued in NJ

Legal business name

PSYCHIATRY SERVICES

Practice address

180 Tuckerton Rd
Suite 11
Medford, NJ 08055-8802

Phone

(609) 536-9890

Fax

(609) 423-0970

NPI assigned

Aug 1, 2013

Last updated

Aug 1, 2013By 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

Mr. Michael B Miller

Title

Ceo

Phone

(609) 536-9890

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1952733875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TUCKERTON RD",
            "address_2": "SUITE 11",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558802",
            "telephone_number": "609-536-9890",
            "fax_number": "609-423-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TUCKERTON RD",
            "address_2": "SUITE 11",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558802",
            "telephone_number": "609-536-9890",
            "fax_number": "609-423-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-536-9890",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": "26NJ00099700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Medford, NJ
• Providers in Medford, NJ by specialty
• Preferred Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.