| None | |
|
12 Van Gogh Dr East Windsor NJ 08520-2999 | |
| (609) 721-2227 | |
| Not Available |
| Full Name | None |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12 Van Gogh Dr, East Windsor, New Jersey |
| Authorized Official Name and Position | Kamalathara Srikanth (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6097212227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 12 Van Gogh Dr East Windsor NJ 08520-2999 Ph: (609) 721-2227 | None 12 Van Gogh Dr East Windsor NJ 08520-2999 Ph: (609) 721-2227 |
| NPI Number | 1326309428 |
|---|---|
| Provider Enumeration Date | 06/05/2012 |
| Last Update Date | 06/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326309428 | NPI | - | NPPES |
| 1396046157 | Other | NJ | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1-10-7089 (New Jersey) | Primary |
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