Organization
BLOOMFIELD HEALTH PAVILION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSTISLAV VILSHTEYN (CEO)
(718) 813-4556
Entity
Organization
Contact information
Practice address
86 BLOOMFIELD AVE, 1ST FLOOR & BASEMENT, NEWARK, NJ 07104-1905
(973) 230-3631
(973) 230-3474
Mailing address
86 BLOOMFIELD AVE, 1ST FLOOR & BASEMENT, NEWARK, NJ 07104-1905
(973) 230-3631
(973) 230-3474
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
051A267
NJ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
051A267
NJ
103TA0700X
Adult Development & Aging Psychologist
051A267
NJ
103TB0200X
Cognitive & Behavioral Psychologist
051A267
NJ
103TC1900X
Counseling Psychologist
051A267
NJ
103TC2200X
Clinical Child & Adolescent Psychologist
051A267
NJ
103TP2701X
Group Psychotherapy Psychologist
051A267
NJ
103TR0400X
Rehabilitation Psychologist
051A267
NJ
363L00000X
Nurse Practitioner
—
NJ
363LC1500X
Community Health Nurse Practitioner
Primary
—
NJ
363LP2300X
Primary Care Nurse Practitioner
—
NJ
Other
Enumeration date
07/15/2006
Last updated
09/11/2025
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