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Contact Information

EXECUTIVE CENTER FOR PSYCHOLOGICAL MEDICINE
701 WHITE HORSE RD STE C-101
VOORHEES TOWNSHIP, NJ08043-2494
 Phone: 267-918-9672
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Neurology

2084N0400X 13 Physician/Neurology
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychosomatic Medicine

2084P0015X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for EXECUTIVE CENTER FOR PSYCHOLOGICAL MEDICINE · (Female)

NPI Number 1821555376
Status Active
Credentials
Entity Individual
Enumeration date 02/20/2019
Last updated 02/20/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • NJ Medicaid 0202266
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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