| Martina S Dawoud Psyd Llc | |
|
155 Polifly Rd Ste 301 Hackensack NJ 07601-1749 | |
| (551) 294-3732 | |
| Not Available |
| Full Name | Martina S Dawoud Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 155 Polifly Rd Ste 301, Hackensack, New Jersey |
| Authorized Official Name and Position | Martina Dawoud (OWNER) |
| Authorized Official Contact | 5512943732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martina S Dawoud Psyd Llc 155 Polifly Rd Ste 301 Hackensack NJ 07601-1749 Ph: (551) 294-3732 | Martina S Dawoud Psyd Llc 155 Polifly Rd Ste 301 Hackensack NJ 07601-1749 Ph: (551) 294-3732 |
| NPI Number | 1740986702 |
|---|---|
| Provider Enumeration Date | 02/01/2023 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 7719340884 |
|---|---|
| Medicare Enrollment ID | O20230823001902 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740986702 | NPI | - | NPPES |
| 35SI00694200 | Other | NJ | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Martina S Dawoud |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1710699806 PECOS PAC ID: 9830552900 Enrollment ID: I20230823001809 |
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