Organization
PSYCHIATRY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL B MILLER (CEO)
(609) 536-9890
Entity
Organization
Contact information
Practice address
180 TUCKERTON RD, SUITE 11, MEDFORD, NJ 08055-8802
(609) 536-9890
(609) 423-0970
Mailing address
180 TUCKERTON RD, SUITE 11, MEDFORD, NJ 08055-8802
(609) 536-9890
(609) 423-0970
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
26NJ00099700
NJ
Other
Enumeration date
08/01/2013
Last updated
08/01/2013
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