| Footprint New Jersey Limited Liability Company | |
|
121 Newark Ave Ste. 503 Jersey City NJ 07302-5872 | |
| (201) 240-6186 | |
| (201) 763-6606 |
| Full Name | Footprint New Jersey Limited Liability Company |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 121 Newark Ave, Jersey City, New Jersey |
| Authorized Official Name and Position | Sarosh M Cooper (PSYCHOLOGIST) |
| Authorized Official Contact | 2012406186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Footprint New Jersey Limited Liability Company 121 Newark Ave Ste. 503 Jersey City NJ 07302-5872 Ph: (201) 240-6186 | Footprint New Jersey Limited Liability Company 121 Newark Ave Ste. 503 Jersey City NJ 07302-5872 Ph: (201) 240-6186 |
| NPI Number | 1669862199 |
|---|---|
| Provider Enumeration Date | 02/05/2015 |
| Last Update Date | 07/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669862199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35SI00482700 (New Jersey) | Primary |
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