| Sam Khorrami, Ph.d., Pc | |
|
328 Commons Way Building C Toms River NJ 08755 | |
| (732) 278-5615 | |
| Not Available |
| Full Name | Sam Khorrami, Ph.d., Pc |
|---|---|
| Speciality | Psychologist |
| Location | 328 Commons Way, Toms River, New Jersey |
| Authorized Official Name and Position | Sam Khorrami (PRESIDENT) |
| Authorized Official Contact | 7322785615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sam Khorrami, Ph.d., Pc Po Box 269 Brielle NJ 08730 Ph: (732) 278-5615 | Sam Khorrami, Ph.d., Pc 328 Commons Way Building C Toms River NJ 08755 Ph: (732) 278-5615 |
| NPI Number | 1689766974 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0648249888 |
|---|---|
| Medicare Enrollment ID | O20040925000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689766974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35S10041560 (New Jersey) | Primary |
| Provider Name | Sam Khorrami |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235224155 PECOS PAC ID: 3274502414 Enrollment ID: I20040925000011 |
| Provider Name | Judith M Kern |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1194870816 PECOS PAC ID: 1850320755 Enrollment ID: I20050811000098 |
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