Provider Demographics
NPI:1396354130
Name:DIGNIPSYCH HEALTH SERVICES
Entity type:Organization
Organization Name:DIGNIPSYCH HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JALLOH
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:856-625-5805
Mailing Address - Street 1:1951 N BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-3465
Mailing Address - Country:US
Mailing Address - Phone:856-625-5805
Mailing Address - Fax:
Practice Address - Street 1:1951 N BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-3465
Practice Address - Country:US
Practice Address - Phone:856-625-5805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty