| Bergen Cbt, Llc | |
|
44 Godwin Ave Midland Park NJ 07432-1969 | |
| (201) 632-1548 | |
| Not Available |
| Full Name | Bergen Cbt, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 44 Godwin Ave, Midland Park, New Jersey |
| Authorized Official Name and Position | Kevin Edward Giangrasso (PRESIDENT) |
| Authorized Official Contact | 2016321548 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Cbt, Llc 480 Gordon Rd Ridgewood NJ 07450-4620 Ph: (718) 644-0639 | Bergen Cbt, Llc 44 Godwin Ave Midland Park NJ 07432-1969 Ph: (201) 632-1548 |
| NPI Number | 1750169561 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750169561 | NPI | - | NPPES |
| 1548545411 | Medicaid | NY | |
| 1265805972 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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