Provider Demographics
NPI:1104086909
Name:NORTH JERSEY PSYCHIATRY ASSOCIATES LLC
Entity type:Organization
Organization Name:NORTH JERSEY PSYCHIATRY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:SAIXI
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:201-282-7299
Mailing Address - Street 1:2035 HAMBURG TPKE
Mailing Address - Street 2:SUITE M
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:973-839-2945
Mailing Address - Fax:973-839-1244
Practice Address - Street 1:2035 HAMBURG TPKE
Practice Address - Street 2:SUITE M
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6251
Practice Address - Country:US
Practice Address - Phone:973-839-2945
Practice Address - Fax:973-839-1244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA081843002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
$$$$$$$$$OtherSSN
NJ0144321Medicaid
NJ107277Medicare PIN