| Breakthrough Therapy And Resources | |
|
199 Chancellor Ave Newark NJ 07112-1751 | |
| (646) 382-7410 | |
| Not Available |
| Full Name | Breakthrough Therapy And Resources |
|---|---|
| Speciality | Clinic/Center |
| Location | 199 Chancellor Ave, Newark, New Jersey |
| Authorized Official Name and Position | Jeffrey Tucker (CEO) |
| Authorized Official Contact | 6463827410 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Therapy And Resources 199 Chancellor Ave Newark NJ 07112-1751 Ph: (646) 382-7410 | Breakthrough Therapy And Resources 199 Chancellor Ave Newark NJ 07112-1751 Ph: (646) 382-7410 |
| NPI Number | 1407612435 |
|---|---|
| Provider Enumeration Date | 02/27/2024 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 3274062674 |
|---|---|
| Medicare Enrollment ID | O20250130001650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407612435 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225629694 PECOS PAC ID: 7416487814 Enrollment ID: I20250214001816 |
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