Organization
BERGEN PSYCHIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHSAN JAN (ADMINISTRATOR)
(845) 821-2605
Entity
Organization
Contact information
Practice address
294 STATE ST STE 2, HACKENSACK, NJ 07601-5515
(201) 342-4004
(201) 342-4208
Mailing address
PO BOX 809, TEANECK, NJ 07666-0809
(845) 821-2605
(201) 243-7874
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
MA65065
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7492201
—
NJ
Enumeration date
01/31/2014
Last updated
01/31/2014
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