| Psychiatric Consultation Pc | |
|
122 Plane St 1a Boonton NJ 07005-1760 | |
| (973) 224-5509 | |
| Not Available |
| Full Name | Psychiatric Consultation Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 122 Plane St, Boonton, New Jersey |
| Authorized Official Name and Position | Ghulam Murtaza Bajwa (CEO) |
| Authorized Official Contact | 9732245509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Consultation Pc 122 Plane St 1a Boonton NJ 07005-1760 Ph: (973) 224-5509 | Psychiatric Consultation Pc 122 Plane St 1a Boonton NJ 07005-1760 Ph: (973) 224-5509 |
| NPI Number | 1144641028 |
|---|---|
| Provider Enumeration Date | 12/19/2013 |
| Last Update Date | 01/17/2014 |
| Medicare PECOS PAC ID | 7416175815 |
|---|---|
| Medicare Enrollment ID | O20140827000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144641028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA09089100 (New Jersey) | Primary |
| Provider Name | Ghulam M Bajwa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073713814 PECOS PAC ID: 9335372440 Enrollment ID: I20140730000382 |
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