| Montclair Memory Clinic Llc | |
|
70 Park Street Suite 207 Montclair NJ 07042-2960 | |
| (973) 743-4555 | |
| (973) 743-4055 |
| Full Name | Montclair Memory Clinic Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 70 Park Street, Montclair, New Jersey |
| Authorized Official Name and Position | Jacqueline A Rondeau (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9737434555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Montclair Memory Clinic Llc Po Box 8121 Glen Ridge NJ 07028-8121 Ph: (973) 743-4555 | Montclair Memory Clinic Llc 70 Park Street Suite 207 Montclair NJ 07042-2960 Ph: (973) 743-4555 |
| NPI Number | 1114396835 |
|---|---|
| Provider Enumeration Date | 09/23/2015 |
| Last Update Date | 04/15/2016 |
| Medicare PECOS PAC ID | 5193025906 |
|---|---|
| Medicare Enrollment ID | O20151201001298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114396835 | NPI | - | NPPES |
| 0051560 | Medicaid | NJ |
| Provider Name | Jacqueline Ann Rondeau |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285622217 PECOS PAC ID: 1355302472 Enrollment ID: I20041022000125 |
| Provider Name | Monica R Christian |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1194905042 PECOS PAC ID: 1456537141 Enrollment ID: I20110513000244 |
| Provider Name | Elizabet Santana Marmon-halm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487282901 PECOS PAC ID: 5799116141 Enrollment ID: I20200519001267 |
| Provider Name | Sarah E Jarocki |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1447769484 PECOS PAC ID: 9830505593 Enrollment ID: I20210304002117 |
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