| Krishna Anderson Ph. D., Llc | |
|
323 Godwin Ave Midland Park NJ 07432-1534 | |
| (201) 444-3533 | |
| (201) 652-9748 |
| Full Name | Krishna Anderson Ph. D., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 323 Godwin Ave, Midland Park, New Jersey |
| Authorized Official Name and Position | Krishna Anderson (OWNER) |
| Authorized Official Contact | 2014443533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Krishna Anderson Ph. D., Llc 323 Godwin Ave Midland Park NJ 07432-1534 Ph: (201) 444-3533 | Krishna Anderson Ph. D., Llc 323 Godwin Ave Midland Park NJ 07432-1534 Ph: (201) 444-3533 |
| NPI Number | 1063790764 |
|---|---|
| Provider Enumeration Date | 07/28/2011 |
| Last Update Date | 07/28/2011 |
| Medicare PECOS PAC ID | 7810310760 |
|---|---|
| Medicare Enrollment ID | O20200710000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063790764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 4864 (New Jersey) | Primary |
| Provider Name | Krishna Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700164407 PECOS PAC ID: 1355764200 Enrollment ID: I20200710000085 |
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