BERGEN PSYCHIATRIC CARE LLC (NPI# 1295255149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295255149 |
| Entity Type | Organization |
| Organization Name | BERGEN PSYCHIATRIC CARE LLC |
| Practice Address |
65 N Maple Ave Ste 104 Ridgewood NJ 07450-3233 |
| Practice Telephone | 2019569483 |
| Practice Fax Number | 2012885262 |
| Mailing Telephone | 2019569483 |
| Mailing Fax Number | 2012885262 |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2019-03-18 |
| Authorized Official Name | MINI THOMAS (CCRP) |
| Authorized Official Telephone | 2019569483 |
| Authorized Official Credential | MBBS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | STATE LICENCE | 25MA09523700 | 01 |
| Street Address |
65 N MAPLE AVE STE 104 |
| City | RIDGEWOOD |
| State | NJ |
| Zip Code | 07450-3233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619490950 | Marek Belz LLC | Psychiatry & Neurology | 65 N Maple Ave Ste 104, Ridgewood, NJ 07450-3233 | 2017-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675857 | Children's Aid and Family Services, Inc. | Behavioral Analyst | 213 Larue Road, W. Milford, NJ 07450 | 2019-05-28 |
| 1962065979 | Corey Chan | Student in an Organized Health Care Education/Training Program | 550 Lynn St, Ridgewood, NJ 07450 | 2019-04-16 |
| 1679058200 | Raymond Hawash | Pharmacist | 223 North Van Dien Ave, Ridgewood, NJ 07450 | 2018-09-28 |
| 1548771967 | Leonard Swerdlof | Dentist | 160 S Broad St, Ridgewood, NJ 07450 | 2017-10-12 |
| 1336671114 | Camp Sunshine and Camp Snowflake, Inc. | Respite Care | 1133 East Ridgewood Avenue, Ridgewood, NJ 07450 | 2017-03-30 |
| 1952764862 | Elysium Aesthetics and Vein Care, Inc | Radiology | 400 State Route 17, Ridgewood, NJ 07450 | 2016-03-30 |
| 1780077362 | Paul Walter Dasher | Psychologist | 76 West Ridgewood Avenue, Ridgewood, NJ 07450 | 2015-03-06 |
| 1255750071 | Myron Frank Lesh | Pharmacist | 305 E. Ridgewood Ave., Ridgewood, NJ 07450 | 2014-04-09 |
| 1649612912 | Jane Worthman-leva | Nutritionist | 357 South Irving St, Ridgewood, NJ 07450 | 2013-07-26 |
| 1427398858 | Life Opportunities Unlimited A Non Profit Corp. | Day Training, Developmentally Disabled Services | 75 North Maple Ave, Suite 104, Ridgewood, NJ 07450 | 2013-02-21 |
| Find all providers in zip 07450 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700418563 | Williambecker Md and Nina Sugar Md Child and Adolescentpsychiatry,llc | Psychiatry & Neurology | 589 Franklin Tpke, Ridgewood, NJ 07450-1989 | 2020-02-10 |
| 1184932931 | Alima B. Farooki Md PC | Psychiatry & Neurology | 127 Union St, Suite 106, Ridgewood, NJ 07450-4478 | 2010-09-15 |
| 1336355858 | William Becker | Psychiatry & Neurology | 589 Franklin Tpke, Ridgewood, NJ 07450-1989 | 2007-05-14 |
| 1275748717 | Alima Bibi Farooki | Psychiatry & Neurology | 127 Union St, Suite 106, Ridgewood, NJ 07450-4478 | 2007-05-10 |
| 1861613531 | Steven Jay Wruble | Psychiatry & Neurology | 1250 E Ridgewood Ave, Ridgewood, NJ 07450-3956 | 2007-05-01 |
| 1881755973 | West Bergen Mental Healthcare, Inc. | Psychiatry & Neurology | 120 Chestnut St, Ridgewood, NJ 07450-2504 | 2006-12-12 |
| 1750460754 | Sofia Kondrashin | Psychiatry & Neurology | 120 Chestnut Street, Ridgewood, NJ 07450 | 2006-11-02 |
| 1841214566 | Ravinder N Bhalla | Psychiatry & Neurology | 65 N Maple Ave, Ridgewood, NJ 07450-3233 | 2006-07-26 |
| 1396798120 | Watutantrige Takshan Dealwis | Psychiatry & Neurology | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059079 | Rr & C Associates | Psychiatry & Neurology | 705 Birchfield Dr, Mount Laurel, NJ 08054-4013 | 2019-12-09 |
| 1154888162 | St. Luke's Counseling Medical Center L.L.C. | Psychiatry & Neurology | 59 Seeley Ave, Kearny, NJ 07032-3120 | 2019-02-26 |
| 1194297614 | Childpsych Services, LLC | Psychiatry & Neurology | 940 Cedar Bridge Ave Fl 2, Brick, NJ 08723-4170 | 2018-12-21 |
| 1003279308 | Medisol, LLC | Psychiatry & Neurology | 226 Fisher Ave, Piscataway, NJ 08854-4833 | 2016-04-04 |
| 1043637465 | Jason Dean | Psychiatry & Neurology | 400 Frank W Burr Blvd # 6, Teaneck, NJ 07666-6839 | 2014-03-24 |
| 1184963837 | Prospect Psychiatric Services Limited Liability Company | Psychiatry & Neurology | 344 Prospect Ave Apt 1a, Hackensack, NJ 07601-2602 | 2013-01-31 |
| 1174870034 | Naomi Ambalu | Psychiatry & Neurology | 266 King George Rd Ste G, Warren, NJ 07059-5187 | 2012-08-10 |
| 1699022558 | Nanda Muthusawmy | Psychiatry & Neurology | 210 Malapardis Rd Ste 205, Cedar Knolls, NJ 07927 | 2012-08-10 |
| 1144512674 | Magalie Saint-lot Jacques | Psychiatry & Neurology | 31 Bridgewater Ct, Jackson, NJ 08527-4030 | 2011-05-03 |
| 1043501265 | Kathreen Tharwat Tadrous | Psychiatry & Neurology | 655 E. Jersey Sreet, Trinitas Regional Medical Center, Elizabeth, NJ 07206 | 2011-04-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.