| Bergen Psychological Services, Llc | |
|
1605 John St Ste 208 Fort Lee NJ 07024-2550 | |
| (973) 432-7230 | |
| (201) 794-4499 |
| Full Name | Bergen Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1605 John St Ste 208, Fort Lee, New Jersey |
| Authorized Official Name and Position | Yesenia Flores (OWNER) |
| Authorized Official Contact | 9734327230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Psychological Services, Llc 1605 John St Ste 205b Fort Lee NJ 07024-2581 Ph: (973) 432-7230 | Bergen Psychological Services, Llc 1605 John St Ste 208 Fort Lee NJ 07024-2550 Ph: (973) 432-7230 |
| NPI Number | 1083040232 |
|---|---|
| Provider Enumeration Date | 09/19/2013 |
| Last Update Date | 10/16/2015 |
| Medicare PECOS PAC ID | 5395972202 |
|---|---|
| Medicare Enrollment ID | O20131223001087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083040232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35SI00492800 (New Jersey) | Primary |
| Provider Name | Yesenia Flores-pinos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144577446 PECOS PAC ID: 5597916338 Enrollment ID: I20121105000065 |
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