| Activity And Human Performance Center | |
|
95 Martin Luther King Jr Dr Jersey City NJ 07305-3025 | |
| (201) 332-7077 | |
| (201) 332-7003 |
| Full Name | Activity And Human Performance Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 95 Martin Luther King Jr Dr, Jersey City, New Jersey |
| Authorized Official Name and Position | Mark H Seglin (PRESIDENT) |
| Authorized Official Contact | 9736320710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Activity And Human Performance Center Po Box 32396 Newark NJ 07102-0796 Ph: (973) 632-0710 | Activity And Human Performance Center 95 Martin Luther King Jr Dr Jersey City NJ 07305-3025 Ph: (201) 332-7077 |
| NPI Number | 1407181472 |
|---|---|
| Provider Enumeration Date | 10/08/2009 |
| Last Update Date | 10/08/2009 |
| Medicare PECOS PAC ID | 4082921564 |
|---|---|
| Medicare Enrollment ID | O20150916000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407181472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2138 (New Jersey) | Primary |
| Provider Name | Mark H Seglin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184754632 PECOS PAC ID: 7517057524 Enrollment ID: I20150916000825 |
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