Break The Cycle Trauma Center Inc | |
21 Lexington Ave Bloomfield NJ 07003-5715 | |
(201) 515-3269 | |
Not Available |
Full Name | Break The Cycle Trauma Center Inc |
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Speciality | Psychologist |
Location | 21 Lexington Ave, Bloomfield, New Jersey |
Authorized Official Name and Position | Mariel Buque (CEO) |
Authorized Official Contact | 2015153269 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Break The Cycle Trauma Center Inc 21 Lexington Ave Bloomfield NJ 07003-5715 Ph: () - | Break The Cycle Trauma Center Inc 21 Lexington Ave Bloomfield NJ 07003-5715 Ph: (201) 515-3269 |
NPI Number | 1700626249 |
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Provider Enumeration Date | 05/31/2024 |
Last Update Date | 05/31/2024 |
Certification Date | 05/31/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700626249 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
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