Organization
NOCD NEW JERSEY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY TRUSKY (COO)
(847) 436-3265
Entity
Organization
Contact information
Practice address
177 WILLET ST, PASSAIC, NJ 07055-1929
(847) 436-3265
Mailing address
225 N MICHIGAN AVE STE 1430, CHICAGO, IL 60601-7653
(847) 436-3265
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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