| Nj Memory Center, Llc | |
|
80 Pompton Ave Ste 106 Verona NJ 07044-2913 | |
| (201) 577-8286 | |
| (201) 479-0299 |
| Full Name | Nj Memory Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 80 Pompton Ave Ste 106, Verona, New Jersey |
| Authorized Official Name and Position | Corey J Burchette (FOUNDER) |
| Authorized Official Contact | 2015778286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nj Memory Center, Llc 80 Pompton Ave Ste 106 Verona NJ 07044-2913 Ph: (201) 577-8286 | Nj Memory Center, Llc 80 Pompton Ave Ste 106 Verona NJ 07044-2913 Ph: (201) 577-8286 |
| NPI Number | 1518425040 |
|---|---|
| Provider Enumeration Date | 03/04/2019 |
| Last Update Date | 03/04/2019 |
| Medicare PECOS PAC ID | 6800138413 |
|---|---|
| Medicare Enrollment ID | O20190501001800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518425040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Corey J Burchette |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629354592 PECOS PAC ID: 7911169743 Enrollment ID: I20190501002445 |
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