Organization
ROWANSOM NEWJERSEY INSTITUTE FOR SUCCESSFUL AGING-GERIATRIC PSYCHIATRY
Active
Parent organization
ROWAN UNIVERSITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROWAN UNIVERSITY
Authorized official
KELIYVETTE WORKMAN (DIRECTOR MANAGED CARE & CONTRACTING)
(856) 566-6831
Entity
Organization
Contact information
Practice address
42 E LAUREL RD STE 1800, STRATFORD, NJ 08084-1338
(856) 566-6843
Mailing address
PO BOX 635, BELLMAWR, NJ 08099-0635
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6946208
—
NJ
Enumeration date
05/31/2018
Last updated
05/31/2018
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