| Dr. Naomi Ambalu, Llc | |
|
115 Franklin Tpke Ste 139 Mahwah NJ 07430-1325 | |
| (908) 998-2288 | |
| (705) 995-2043 |
| Full Name | Dr. Naomi Ambalu, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 115 Franklin Tpke Ste 139, Mahwah, New Jersey |
| Authorized Official Name and Position | Naomi Ambalu (OWNER) |
| Authorized Official Contact | 9089982288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Naomi Ambalu, Llc 115 Franklin Tpke Ste 139 Mahwah NJ 07430-1325 Ph: (908) 998-2288 | Dr. Naomi Ambalu, Llc 115 Franklin Tpke Ste 139 Mahwah NJ 07430-1325 Ph: (908) 998-2288 |
| NPI Number | 1780192401 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 09/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780192401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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