| Brian C. Della Pesca Ma Lpc, Llc | |
|
473 Broadway Suite 307 Bayonne NJ 07002 | |
| (973) 980-2955 | |
| (201) 254-9928 |
| Full Name | Brian C. Della Pesca Ma Lpc, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 473 Broadway, Bayonne, New Jersey |
| Authorized Official Name and Position | Brian Charles Della Pasca (OWNER) |
| Authorized Official Contact | 9739802955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian C. Della Pesca Ma Lpc, Llc Po Box 1232 Fair Lawn NJ 07410 Ph: (973) 980-2955 | Brian C. Della Pesca Ma Lpc, Llc 473 Broadway Suite 307 Bayonne NJ 07002 Ph: (973) 980-2955 |
| NPI Number | 1255577052 |
|---|---|
| Provider Enumeration Date | 12/29/2008 |
| Last Update Date | 12/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255577052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00033100 (New Jersey) | Primary |
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