| Alas Poor Yorick Llc | |
|
171 Main St Metuchen NJ 08840-2744 | |
| (732) 443-3558 | |
| Not Available |
| Full Name | Alas Poor Yorick Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 171 Main St, Metuchen, New Jersey |
| Authorized Official Name and Position | Kevin Collery (PRIMARY THERAPIST) |
| Authorized Official Contact | 7324433558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alas Poor Yorick Llc Po Box 1557 New Brunswick NJ 08903-1557 Ph: () - | Alas Poor Yorick Llc 171 Main St Metuchen NJ 08840-2744 Ph: (732) 443-3558 |
| NPI Number | 1578035382 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Medicare PECOS PAC ID | 5799106308 |
|---|---|
| Medicare Enrollment ID | O20200616002428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578035382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kevin J Collery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932508546 PECOS PAC ID: 8729348297 Enrollment ID: I20180131002213 |
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