Provider Demographics
NPI:1104672617
Name:DVH NP IN PSYCHIATRY SERVICES NJ LLC
Entity type:Organization
Organization Name:DVH NP IN PSYCHIATRY SERVICES NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VON HOLTEN
Authorized Official - Suffix:
Authorized Official - Credentials:NPP-BC
Authorized Official - Phone:347-573-9479
Mailing Address - Street 1:2093 PHILADELPHIA PIKE # 7683
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2424
Mailing Address - Country:US
Mailing Address - Phone:347-573-9479
Mailing Address - Fax:347-745-5913
Practice Address - Street 1:111 TOWN SQUARE PL STE 1201
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1724
Practice Address - Country:US
Practice Address - Phone:347-573-9479
Practice Address - Fax:347-745-5913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DVH NP IN PSYCHIATRY SERVICES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty