# NJCRI PHYSICIANS GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTH JERSEY COMMUNITY RESEARCH INITIATIVE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487100657
- **Legal business name:** NORTH JERSEY COMMUNITY RESEARCH INITIATIVE
- **Authorized official:** MR. SHAWN EKWALL MBA (ADMINISTRATOR)
- **Authorized official phone:** (973) 483-3444

## Contact information

- **Practice address:** 393 CENTRAL AVE, NEWARK, NJ 07103-2842
- **Practice address phone:** (973) 483-3444
- **Practice address fax:** (347) 342-0769
- **Mailing address:** 393 CENTRAL AVE, NEWARK, NJ 07103-2842
- **Mailing address phone:** (973) 483-3444
- **Mailing address fax:** (347) 342-0769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 207R00000X | Internal Medicine Physician | 25MA05479500 | NJ | Yes |

## Other

- **Enumeration date:** 08/29/2016
- **Last updated:** 04/12/2017