Organization
INSYTE PSYCHIATRIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYDIA KEISE M.D. (OWNER)
(732) 551-5550
Entity
Organization
Contact information
Practice address
33 PLYMOUTH ST, SUITE 108, MONTCLAIR, NJ 07042-2677
(732) 551-5550
Mailing address
33 PLYMOUTH ST, SUITE 108, MONTCLAIR, NJ 07042-2677
(732) 551-5550
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA08706800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346562857
NPI
NJ
Enumeration date
08/06/2011
Last updated
08/06/2011
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