| Blue Balloon New Jersey Llc | |
|
175 Belgrove Dr Kearny NJ 07032-1507 | |
| (201) 216-9500 | |
| Not Available |
| Full Name | Blue Balloon New Jersey Llc |
|---|---|
| Speciality | Psychologist |
| Location | 175 Belgrove Dr, Kearny, New Jersey |
| Authorized Official Name and Position | David Sussman (MEMBER) |
| Authorized Official Contact | 2012169500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Balloon New Jersey Llc 175 Belgrove Dr Kearny NJ 07032-1507 Ph: (201) 216-9500 | Blue Balloon New Jersey Llc 175 Belgrove Dr Kearny NJ 07032-1507 Ph: (201) 216-9500 |
| NPI Number | 1346846508 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346846508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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