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Organization

BLOSSOM NP IN PSYCHIATRY HEALTH PLL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DALIYA ANOO CHANDROTH (OWNER)
(201) 214-0400
Entity
Organization

Contact information

Practice address
15-01 BROADWAY STE 24, FAIR LAWN, NJ 07410-6006
(833) 325-6766
Mailing address
15-01 BROADWAY STE 24, FAIR LAWN, NJ 07410-6006
(833) 325-6766

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
04/18/2023
Last updated
04/18/2023
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