| Rowan Integrated Special Needs Bh | |
|
1474 Tanyard Rd Sewell NJ 08080-4111 | |
| (856) 566-6034 | |
| (856) 566-6208 |
| Full Name | Rowan Integrated Special Needs Bh |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1474 Tanyard Rd, Sewell, New Jersey |
| Authorized Official Name and Position | Keli Workman (DIRECTOR OF MANAGED CARE & CONTRACT) |
| Authorized Official Contact | 8565666831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rowan Integrated Special Needs Bh Po Box 71356 Philadelphia PA 19176-1356 Ph: (856) 566-6413 | Rowan Integrated Special Needs Bh 1474 Tanyard Rd Sewell NJ 08080-4111 Ph: (856) 566-6034 |
| NPI Number | 1730562455 |
|---|---|
| Provider Enumeration Date | 06/30/2015 |
| Last Update Date | 12/05/2022 |
| Certification Date | 12/05/2022 |
| Medicare PECOS PAC ID | 2668773581 |
|---|---|
| Medicare Enrollment ID | O20151218001492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730562455 | NPI | - | NPPES |
| DW2417 | Other | NJ | RAILROAD MEDICARE |
| 0491829 | Medicaid | NJ | |
| 0487317 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Wendy F Aita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023206653 PECOS PAC ID: 8628165594 Enrollment ID: I20151218001625 |
| Provider Name | Mang Hin Yip |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205392628 PECOS PAC ID: 4880020619 Enrollment ID: I20200214000034 |
| Provider Name | Folawewo A Ajayi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922632520 PECOS PAC ID: 5092138966 Enrollment ID: I20200710000780 |
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