| Psychiatric Care Professional Association | |
|
99 Ivy Ln Tenafly NJ 07670-2409 | |
| (201) 970-4300 | |
| (800) 352-3015 |
| Full Name | Psychiatric Care Professional Association |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 99 Ivy Ln, Tenafly, New Jersey |
| Authorized Official Name and Position | Wei Wang (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9176824300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Care Professional Association 99 Ivy Ln Tenafly NJ 07670-2409 Ph: (917) 682-4300 | Psychiatric Care Professional Association 99 Ivy Ln Tenafly NJ 07670-2409 Ph: (201) 970-4300 |
| NPI Number | 1669777280 |
|---|---|
| Provider Enumeration Date | 01/12/2011 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Medicare PECOS PAC ID | 3971782913 |
|---|---|
| Medicare Enrollment ID | O20110124000748 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669777280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA07675700 (New Jersey) | Primary |
| Provider Name | Wei Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902813876 PECOS PAC ID: 3274574439 Enrollment ID: I20050518000204 |
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