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Organization

STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL

Active
Other names
Trenton Psychiatric Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
EVAN FIEBUSCH M.D. (PSYCHIATRIST)
(609) 633-1563
Entity
Organization

Contact information

Practice address
101 SULLIVAN WAY, TRENTON, NJ 08628-3425
(609) 633-1562
(609) 633-8527
Mailing address
101 SULLIVAN WAY, TRENTON, NJ 08628-3425
(609) 633-1562
(609) 633-8527

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
692713
MEDICARE GROUP BILLING
NJ
Enumeration date
09/22/2006
Last updated
05/06/2015
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