Tomcat Psych Services Llc | |
1 Bay Ave Montclair NJ 07042-4837 | |
(973) 429-6000 | |
Not Available |
Full Name | Tomcat Psych Services Llc |
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Speciality | Psychologist |
Location | 1 Bay Ave, Montclair, New Jersey |
Authorized Official Name and Position | Karen Vaughn (OFFICER) |
Authorized Official Contact | 9732511132 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tomcat Psych Services Llc 100 Witmer Rd Ste 220 Horsham PA 19044-2279 Ph: () - | Tomcat Psych Services Llc 1 Bay Ave Montclair NJ 07042-4837 Ph: (973) 429-6000 |
NPI Number | 1588255277 |
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Provider Enumeration Date | 01/27/2021 |
Last Update Date | 03/22/2023 |
Certification Date | 03/22/2023 |
Medicare PECOS PAC ID | 6002215209 |
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Medicare Enrollment ID | O20210520000110 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588255277 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Secondary |
103TH0004X | Psychologist - Health | (* (Not Available)) | Primary |
Provider Name | Russell H. Harris |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1598714800 PECOS PAC ID: 2163335308 Enrollment ID: I20040421000154 |
Provider Name | George C Kruse |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417030289 PECOS PAC ID: 3274639067 Enrollment ID: I20090324000652 |
Provider Name | Veronica M Jensen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700021391 PECOS PAC ID: 9830247568 Enrollment ID: I20090506000295 |
Provider Name | Juan Riestra |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1841255320 PECOS PAC ID: 9234263625 Enrollment ID: I20100820000622 |
Provider Name | Jonathan A Hertz |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1881747152 PECOS PAC ID: 8820014160 Enrollment ID: I20180522000313 |
Provider Name | Sylvana J Garcia Morales |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699280099 PECOS PAC ID: 8224376538 Enrollment ID: I20190212002106 |
Provider Name | Carline Archille |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215584107 PECOS PAC ID: 0749512135 Enrollment ID: I20191105000983 |
Provider Name | Olivia M Gibson-delaney |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1881128924 PECOS PAC ID: 2961748827 Enrollment ID: I20210823000029 |
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