| Mbj Psychiatric Nurse Practitioner Llc | |
|
244 Hendrickson Ave Edgewater Park NJ 08010-2024 | |
| (609) 575-8483 | |
| Not Available |
| Full Name | Mbj Psychiatric Nurse Practitioner Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 244 Hendrickson Ave, Edgewater Park, New Jersey |
| Authorized Official Name and Position | Ernst Renondeau (OWNER) |
| Authorized Official Contact | 6095758483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mbj Psychiatric Nurse Practitioner Llc 6 Kilmer Rd Ste B Edison NJ 08817-2432 Ph: (640) 266-4033 | Mbj Psychiatric Nurse Practitioner Llc 244 Hendrickson Ave Edgewater Park NJ 08010-2024 Ph: (609) 575-8483 |
| NPI Number | 1912789215 |
|---|---|
| Provider Enumeration Date | 10/20/2023 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/06/2023 |
| Medicare PECOS PAC ID | 3375052186 |
|---|---|
| Medicare Enrollment ID | O20250603002900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912789215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ernst Renondeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134714546 PECOS PAC ID: 8527455567 Enrollment ID: I20220421002701 |
Twin Oaks Community Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1461 Perkins Ln, Edgewater Park, NJ 08010 Phone: 609-267-5928 | |
Joseph C Titone Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4 Candlelight Dr, Edgewater Park, NJ 08010 Phone: 609-880-0388 Fax: 609-880-1348 |