| Pm Vietze Phd Llc | |
|
957 Cedarbrook Road Plainfield NJ 07060-2646 | |
| (347) 668-4992 | |
| (908) 757-8322 |
| Full Name | Pm Vietze Phd Llc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 957 Cedarbrook Road, Plainfield, New Jersey |
| Authorized Official Name and Position | Peter Vietze (PRESIDENT) |
| Authorized Official Contact | 3476684992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pm Vietze Phd Llc 957 Cedarbrook Road Plainfield NJ 07060-2646 Ph: (347) 668-4992 | Pm Vietze Phd Llc 957 Cedarbrook Road Plainfield NJ 07060-2646 Ph: (347) 668-4992 |
| NPI Number | 1548879984 |
|---|---|
| Provider Enumeration Date | 07/30/2020 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548879984 | NPI | - | NPPES |
| 0625558 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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