Provider Demographics
NPI:1083434716
Name:TRAINED MIND PSYCHIATRY LLC
Entity type:Organization
Organization Name:TRAINED MIND PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ APN
Authorized Official - Prefix:
Authorized Official - First Name:NKEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-716-1558
Mailing Address - Street 1:43 KARNAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854
Mailing Address - Country:US
Mailing Address - Phone:201-716-1558
Mailing Address - Fax:201-716-1557
Practice Address - Street 1:7000 HADLEY RD # 1180
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1139
Practice Address - Country:US
Practice Address - Phone:201-716-1558
Practice Address - Fax:201-716-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty