Provider Demographics
NPI:1386876688
Name:PASCACK VALLEY PSYCHIATRIC INSTITUTE, INC.
Entity type:Organization
Organization Name:PASCACK VALLEY PSYCHIATRIC INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRITESH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-358-0400
Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-0054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:185 CEDAR LN
Practice Address - Street 2:SUITE U6
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4316
Practice Address - Country:US
Practice Address - Phone:201-358-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty