Organization
STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Active
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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