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Organization

NJCRI PHYSICIANS GROUP PC

Active
Parent organization
NORTH JERSEY COMMUNITY RESEARCH INITIATIVE
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTH JERSEY COMMUNITY RESEARCH INITIATIVE
Authorized official
MR. SHAWN EKWALL MBA (ADMINISTRATOR)
(973) 483-3444
Entity
Organization

Contact information

Practice address
393 CENTRAL AVE, NEWARK, NJ 07103-2842
(973) 483-3444
(347) 342-0769
Mailing address
393 CENTRAL AVE, NEWARK, NJ 07103-2842
(973) 483-3444
(347) 342-0769

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
207R00000X
Internal Medicine Physician
Primary
25MA05479500
NJ

Other

Enumeration date
08/29/2016
Last updated
04/12/2017
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