| Avicenna Medical Center | |
|
129 Valley Rd 2nd Floor Montclair NJ 07042-2331 | |
| (973) 746-2620 | |
| (973) 746-2579 |
| Full Name | Avicenna Medical Center |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 129 Valley Rd, Montclair, New Jersey |
| Authorized Official Name and Position | Anna Michele Rossi (PRESIDENT/PSYCHIATRIST) |
| Authorized Official Contact | 9737462620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avicenna Medical Center 129 Valley Rd 2nd Floor Montclair NJ 07042-2331 Ph: (973) 746-2620 | Avicenna Medical Center 129 Valley Rd 2nd Floor Montclair NJ 07042-2331 Ph: (973) 746-2620 |
| NPI Number | 1073904801 |
|---|---|
| Provider Enumeration Date | 02/16/2015 |
| Last Update Date | 02/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073904801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 25MB07627000 (New Jersey) | Primary |
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