# FIRST CHOICE RECOVERY CENTER PC

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

## Provider details

- **NPI number:** 1962071910
- **Authorized official:** MANOJ PUTHIYATHU MD (OWNER)
- **Authorized official phone:** (201) 956-9483

## Contact information

- **Practice address:** 61 N MAPLE AVE STE 302, RIDGEWOOD, NJ 07450-3232
- **Practice address phone:** (201) 956-9483
- **Practice address fax:** (201) 288-5262
- **Mailing address:** 61 N MAPLE AVE STE 302, RIDGEWOOD, NJ 07450-3232
- **Mailing address phone:** (201) 956-9483
- **Mailing address fax:** (201) 288-5262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | Yes |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2021
- **Last updated:** 06/23/2021