Organization
DR. NAOMI AMBALU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAOMI AMBALU DO (OWNER)
(908) 998-2288
Entity
Organization
Contact information
Practice address
115 FRANKLIN TPKE STE 139, MAHWAH, NJ 07430-1325
(908) 998-2288
(705) 995-2043
Mailing address
115 FRANKLIN TPKE STE 139, MAHWAH, NJ 07430-1325
(908) 998-2288
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/16/2018
Last updated
09/25/2018
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