| Edge New Jersey | |
|
3 Executive Dr Morris Plains NJ 07950-2155 | |
| (973) 285-0006 | |
| (973) 285-0067 |
| Full Name | Edge New Jersey |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3 Executive Dr, Morris Plains, New Jersey |
| Authorized Official Name and Position | Laurie Litt (CEO) |
| Authorized Official Contact | 9732850006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edge New Jersey 3 Executive Dr Morris Plains NJ 07950-2155 Ph: (973) 285-0006 | Edge New Jersey 3 Executive Dr Morris Plains NJ 07950-2155 Ph: (973) 285-0006 |
| NPI Number | 1881025161 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 04/14/2020 |
| Certification Date | 04/14/2020 |
| Medicare PECOS PAC ID | 0345661591 |
|---|---|
| Medicare Enrollment ID | O20200527000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881025161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Maryann B Pillarella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780131896 PECOS PAC ID: 4789005943 Enrollment ID: I20200527000496 |
| Provider Name | Laurie Litt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831738673 PECOS PAC ID: 4981025137 Enrollment ID: I20200527000757 |
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