| Jersey Shore Psychiatric Services Llc | |
|
9 Professional Cir Suite 202 Colts Neck NJ 07722-2426 | |
| (848) 482-7764 | |
| (732) 303-2227 |
| Full Name | Jersey Shore Psychiatric Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9 Professional Cir, Colts Neck, New Jersey |
| Authorized Official Name and Position | Muhammad A Abbas (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8484827764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jersey Shore Psychiatric Services Llc 9 Professional Cir Suite 202 Colts Neck NJ 07722-2426 Ph: (848) 482-7764 | Jersey Shore Psychiatric Services Llc 9 Professional Cir Suite 202 Colts Neck NJ 07722-2426 Ph: (848) 482-7764 |
| NPI Number | 1417499260 |
|---|---|
| Provider Enumeration Date | 11/10/2016 |
| Last Update Date | 03/27/2017 |
| Medicare PECOS PAC ID | 0143500736 |
|---|---|
| Medicare Enrollment ID | O20161219000955 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417499260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 25MA09092000 (New Jersey) | Primary |
| Provider Name | Allan Iuspa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396924338 PECOS PAC ID: 1951341239 Enrollment ID: I20050505000760 |
| Provider Name | Muhammad A Abbas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396955951 PECOS PAC ID: 1153513015 Enrollment ID: I20120727000602 |
| Provider Name | Kathleen G Waldron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558587543 PECOS PAC ID: 6901847995 Enrollment ID: I20131022000305 |
| Provider Name | Patricia A Comerford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477875698 PECOS PAC ID: 6608990528 Enrollment ID: I20150930001427 |
| Provider Name | Geralda Vilus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407201627 PECOS PAC ID: 8325337710 Enrollment ID: I20160525002398 |
| Provider Name | Nicole Elizabeth Cichetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790355931 PECOS PAC ID: 9133526957 Enrollment ID: I20210921003681 |
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