| North Ward Behavioral Health Center Llc | |
|
485-491 Mt Prospect Ave Newark NJ 07104 | |
| (973) 672-8573 | |
| (973) 675-0040 |
| Full Name | North Ward Behavioral Health Center Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 485-491 Mt Prospect Ave, Newark, New Jersey |
| Authorized Official Name and Position | Alexander Salerno (OWNER) |
| Authorized Official Contact | 9736722455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Ward Behavioral Health Center Llc 485-491 Mt Prospect Ave Newark NJ 07104 Ph: (973) 672-8573 | North Ward Behavioral Health Center Llc 485-491 Mt Prospect Ave Newark NJ 07104 Ph: (973) 672-8573 |
| NPI Number | 1326679218 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 01/29/2020 |
| Medicare PECOS PAC ID | 3375965569 |
|---|---|
| Medicare Enrollment ID | O20200616002461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326679218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | Alexander G Salerno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962476903 PECOS PAC ID: 3375455959 Enrollment ID: I20031105000696 |
| Provider Name | Nilay Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154372621 PECOS PAC ID: 5890704811 Enrollment ID: I20070816000577 |
| Provider Name | Ayme Veronica Frometa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669600995 PECOS PAC ID: 0941515720 Enrollment ID: I20150824000994 |
| Provider Name | Tia Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871997833 PECOS PAC ID: 3577872431 Enrollment ID: I20151016001031 |
| Provider Name | Ariana Luciano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003352212 PECOS PAC ID: 2961836416 Enrollment ID: I20191217000738 |
| Provider Name | Stephanie Campos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255881660 PECOS PAC ID: 5395112833 Enrollment ID: I20221112000215 |
| Provider Name | Colleen Ferenchak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558060012 PECOS PAC ID: 2466899455 Enrollment ID: I20240326003468 |
| Provider Name | Jose Ignacio Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942074695 PECOS PAC ID: 9638517303 Enrollment ID: I20240402000052 |
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