| Centro Feed | |
|
114 Forest View Dr Avenel NJ 07001-2184 | |
| (848) 467-1409 | |
| Not Available |
| Full Name | Centro Feed |
|---|---|
| Speciality | Psychologist - Health Service |
| Location | 114 Forest View Dr, Avenel, New Jersey |
| Authorized Official Name and Position | Candrick C. Darkashade (PRESIDENT-CEO) |
| Authorized Official Contact | 8484671409 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Feed 114 Forest View Dr Avenel NJ 07001-2184 Ph: (848) 467-1409 | Centro Feed 114 Forest View Dr Avenel NJ 07001-2184 Ph: (848) 467-1409 |
| NPI Number | 1790306512 |
|---|---|
| Provider Enumeration Date | 05/04/2020 |
| Last Update Date | 05/04/2020 |
| Certification Date | 05/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790306512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
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