| Johan Peguero | |
|
855 Broad Ave Apt 41 Ridgefield NJ 07657-1032 | |
| (929) 424-8653 | |
| Not Available |
| Full Name | Johan Peguero |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 855 Broad Ave Apt 41, Ridgefield, New Jersey |
| Authorized Official Name and Position | Johan Peguero (LCSW) |
| Authorized Official Contact | 9294248653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johan Peguero 855 Broad Ave Apt 41 Ridgefield NJ 07657-1032 Ph: (929) 424-8653 | Johan Peguero 855 Broad Ave Apt 41 Ridgefield NJ 07657-1032 Ph: (929) 424-8653 |
| NPI Number | 1700561727 |
|---|---|
| Provider Enumeration Date | 06/19/2023 |
| Last Update Date | 06/19/2023 |
| Certification Date | 06/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700561727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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