# VINEYARD PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124848056
- **Authorized official:** KATHRYN GROLL APRN (OWNER)
- **Authorized official phone:** (646) 831-1227

## Contact information

- **Practice address:** 123 N UNION AVE STE 302, CRANFORD, NJ 07016-2198
- **Practice address phone:** (908) 738-9185
- **Practice address fax:** (908) 282-3250
- **Mailing address:** 5 SUMMIT RD, CRANFORD, NJ 07016-1931
- **Mailing address phone:** (646) 831-1227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2024
- **Last updated:** 10/15/2024