AVICENNA MEDICAL CENTER (NPI# 1073904801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073904801 |
| Entity Type | Organization |
| Organization Name | AVICENNA MEDICAL CENTER |
| Practice Address |
129 Valley Rd 2nd Floor Montclair NJ 07042-2331 |
| Practice Telephone | 9737462620 |
| Practice Fax Number | 9737462579 |
| Mailing Telephone | 9737462620 |
| Mailing Fax Number | 9737462579 |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-02-16 |
| Authorized Official Name | DR. ANNA MICHELE ROSSI (PRESIDENT/PSYCHIATRIST) |
| Authorized Official Telephone | 9737462620 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
25MB07627000 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
129 VALLEY RD 2ND FLOOR |
| City | MONTCLAIR |
| State | NJ |
| Zip Code | 07042-2331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144578584 | Cynthia Marie Raines | Counselor | 129 Valley Rd, Montclair, NJ 07042-2331 | 2012-08-15 |
| 1548759715 | 4mind2body Therapeutic Institute L.L.C. | Marriage & Family Therapist | 129 Valley Rd, Montclair, NJ 07042-2331 | 2018-05-03 |
| 1942707492 | Rhea Bensman Psyd LLC | Psychologist | 129 Valley Rd, Montclair, NJ 07042-2331 | 2018-04-11 |
| 1902310196 | Wintertree Psychotherapy | Clinic/Center | 129 Valley Rd, Montclair, NJ 07042-2331 | 2017-11-27 |
| 1205365160 | Karen Lee Benenson | Social Worker | 129 Valley Rd, Montclair, NJ 07042-2331 | 2017-06-05 |
| 1255871307 | Clinical Office for Progress and Empowerment | Social Worker | 129 Valley Rd, 2nd Floor, Montclair, NJ 07042-2331 | 2017-03-07 |
| 1942752902 | Christine Morales | Social Worker | 129 Valley Rd, 2nd Floor, Montclair, NJ 07042-2331 | 2016-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003451261 | Montclair Art Museum | Voluntary or Charitable | 3 South Mountain Avenue, Montclair, NJ 07042 | 2019-11-12 |
| 1740847797 | Magnify In-home Eyecare | Optometrist | Little Nursing Home, 71 Christopher Street, Montclair, NJ 07042 | 2019-05-24 |
| 1326539073 | Wendy C Kaplan | Social Worker | 460 Bloomfield Ave Suite 209, Montclair, NJ 07042 | 2018-05-29 |
| 1538666342 | Mary Elizabeth Mcgaughan | Psychologist | 239 Grove Street, Montclair, NJ 07042 | 2018-04-09 |
| 1023546777 | Alexander Scott Fisher | Dentist | 39 S Fullerton Ave Fl 2, Montclair, NJ 07042 | 2017-05-25 |
| 1942754825 | Kaity Rodriguez | Social Worker | 105 Grove St., Montclair, NJ 07042 | 2016-08-09 |
| 1144678889 | Melissa Cardinal | Nurse Practitioner | 36 Valley Road, 529, Montclair, NJ 07042 | 2016-06-02 |
| 1528413655 | Bellapianta Orthopaedics and Sports Medicine LLC | Orthopaedic Surgery | 1 Bay Avenue, Harries Pavilion, Suite 1, Montclair, NJ 07042 | 2016-04-26 |
| 1740647643 | Wendalyn Leona Browne | Massage Therapist | 37 Watchung Plaza, 2l, Montclair, NJ 07042 | 2016-01-22 |
| 1891168670 | Patience Moore | Social Worker | 460 Bloomfield Ave Ste 306, Montclair, NJ 07042 | 2015-11-03 |
| Find all providers in zip 07042 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578855755 | Saiz, M.d. LLC | Psychologist | 2000 Bergenline Ave, Union City, NJ 07087-3350 | 2011-05-06 |
| 1770721854 | Psychiatric Associates of North Jersey, Inc | Psychologist | 288 Leonard Pl, Paramus, NJ 07652-4517 | 2009-01-28 |
| 1891957379 | Marina Moshkovich | Psychologist | Njsp Third and Cass Street, Trenton, NJ 08625 | 2008-06-26 |
| 1912124892 | Jesse Mintz | Psychologist | 10 Auer Ct Ste D, East Brunswick, NJ 08816-5848 | 2007-04-20 |
| 1962628818 | Peter S Mueller, M.d.,p.a | Psychologist | 601 Ewing St # A, Suite B-3, Princeton, NJ 08540-2757 | 2007-04-18 |
| 1861876419 | Fairlawn Behavioral Associates LLC | Psychologist | 15-01 Broadway, Suite# 10b, Fair Lawn, NJ 07410-6003 | 2015-07-14 |
| 1902297344 | Princeton Psychiatric Centers, Pa | Psychologist | 256 Bunn Dr, Suite 6, Princeton, NJ 08540-2859 | 2015-02-06 |
| 1639514946 | Deborra M. Torres, Msn Pmhnp LLC | Psychologist | 5 N Main St, Suite A, Medford, NJ 08055-2439 | 2013-05-01 |
| 1851677033 | Valeo Behavioral Health, Inc. | Psychologist | 2911 Route 88, Suite E8, Point Pleasant Boro, NJ 08742-2871 | 2011-11-01 |
| 1285953976 | Pinnicle Behavioral Health, LLC | Psychologist | 2911 Route 88, Suite E8, Point Pleasant, NJ 08742-2871 | 2010-05-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.