| Purpleblue Behavioral Health | |
|
34 Union Ave Irvington NJ 07111-3219 | |
| (551) 358-7382 | |
| Not Available |
| Full Name | Purpleblue Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 34 Union Ave, Irvington, New Jersey |
| Authorized Official Name and Position | Regina Inokon (PMHNP-BC/CO-OWNER) |
| Authorized Official Contact | 5513587383 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Purpleblue Behavioral Health 290 Clermont Ter Union NJ 07083-8003 Ph: (551) 358-7383 | Purpleblue Behavioral Health 34 Union Ave Irvington NJ 07111-3219 Ph: (551) 358-7382 |
| NPI Number | 1780428623 |
|---|---|
| Provider Enumeration Date | 06/25/2024 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/24/2024 |
| Medicare PECOS PAC ID | 7719411644 |
|---|---|
| Medicare Enrollment ID | O20241114000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780428623 | NPI | - | NPPES |
| Provider Name | Regina N Inokon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982210969 PECOS PAC ID: 8921401241 Enrollment ID: I20210723003331 |
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