Organization
ENVISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM MOSCHELLA (CONSULTANT)
(973) 699-1884
Entity
Organization
Contact information
Practice address
60 POMPTON AVE, VERONA, NJ 07044-2946
(973) 271-5802
Mailing address
111 OLD CHESTER RD, ESSEX FELLS, NJ 07021-1625
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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