| Ideal Psych Behavioral Health Limited Liability Company | |
|
1145 Bordentown Ave, 3rd Floor Room 18 Parlin NJ 08859-0885 | |
| (862) 264-8062 | |
| (862) 418-4933 |
| Full Name | Ideal Psych Behavioral Health Limited Liability Company |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1145 Bordentown Ave, 3rd Floor Room 18, Parlin, New Jersey |
| Authorized Official Name and Position | Emily Wanyoike (PRESIDENT) |
| Authorized Official Contact | 8622648062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Psych Behavioral Health Limited Liability Company 23 Quincy Cir Dayton NJ 08810-1331 Ph: (862) 264-8062 | Ideal Psych Behavioral Health Limited Liability Company 1145 Bordentown Ave, 3rd Floor Room 18 Parlin NJ 08859-0885 Ph: (862) 264-8062 |
| NPI Number | 1639957772 |
|---|---|
| Provider Enumeration Date | 09/19/2023 |
| Last Update Date | 05/13/2025 |
| Certification Date | 05/13/2025 |
| Medicare PECOS PAC ID | 6608225305 |
|---|---|
| Medicare Enrollment ID | O20231206002801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639957772 | NPI | - | NPPES |
| 732163331 | Medicaid | NJ |
| Provider Name | Emily Wanyoike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790375400 PECOS PAC ID: 6709291560 Enrollment ID: I20210209002261 |
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