Ellen Grosovsky, Llc | |
101 Cedar Ln Ste 304 Teaneck NJ 07666-4417 | |
(201) 567-5184 | |
Not Available |
Full Name | Ellen Grosovsky, Llc |
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Speciality | Clinic/Center |
Location | 101 Cedar Ln Ste 304, Teaneck, New Jersey |
Authorized Official Name and Position | Ellen Grosovsky (THERAPIST) |
Authorized Official Contact | 2015675184 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ellen Grosovsky, Llc 8 Knoll Rd Tenafly NJ 07670-1024 Ph: (201) 567-5184 | Ellen Grosovsky, Llc 101 Cedar Ln Ste 304 Teaneck NJ 07666-4417 Ph: (201) 567-5184 |
NPI Number | 1437674595 |
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Provider Enumeration Date | 08/10/2017 |
Last Update Date | 06/16/2018 |
Medicare PECOS PAC ID | 7416216478 |
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Medicare Enrollment ID | O20180119000874 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437674595 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 44SC05736700 (New Jersey) | Primary |
Provider Name | Ellen Handmaker Grosovsky |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1578087581 PECOS PAC ID: 8325307382 Enrollment ID: I20180119000970 |
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