Organization
HACKENSACK MERIDIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI CHIARELLO MSE LCSW (CLINICAL SUPERVISOR)
(732) 836-4140
Entity
Organization
Contact information
Practice address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4664
Mailing address
425 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 836-4664
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
44SL06131500
NJ
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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