Organization
MBJ PSYCHIATRIC NURSE PRACTITIONER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNST RENONDEAU APN (OWNER)
(609) 575-8483
Entity
Organization
Contact information
Practice address
244 HENDRICKSON AVE, EDGEWATER PARK, NJ 08010-2024
(609) 575-8483
Mailing address
6 KILMER RD STE B, EDISON, NJ 08817-2432
(640) 266-4033
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/20/2023
Last updated
11/10/2023
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