Provider Demographics
NPI:1134080773
Name:CREATIVE CARE PSYCHIATRY LLC
Entity type:Organization
Organization Name:CREATIVE CARE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HADJIESMAEILOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-980-5042
Mailing Address - Street 1:1 MARINE PLZ STE 307
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6234
Mailing Address - Country:US
Mailing Address - Phone:201-429-5773
Mailing Address - Fax:201-425-3456
Practice Address - Street 1:1 MARINE PLZ STE 307
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6234
Practice Address - Country:US
Practice Address - Phone:201-429-5773
Practice Address - Fax:201-425-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-22
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty