ESSEX PSYCHIATRIC CENTER FOR CHILDREN & ADULTS LLC (NPI# 1396205563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396205563 |
| Entity Type | Organization |
| Organization Name | ESSEX PSYCHIATRIC CENTER FOR CHILDREN & ADULTS LLC |
| Practice Address |
111 Central Ave Newark NJ 07102-1909 |
| Mailing Address |
38 Talbot St Somerset NJ 08873-4600 |
| Practice Telephone | 2018056046 |
| Mailing Telephone | 2018056046 |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-03-23 |
| Authorized Official Name | DR. SONIA DEMETRIOS (MEDICAL DOCTOR) |
| Authorized Official Telephone | 2018056046 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
111 CENTRAL AVE |
| City | NEWARK |
| State | NJ |
| Zip Code | 07102-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780687806 | Sandhya R Makkapati | Specialist | 111 Central Ave, Newark, NJ 07102-1909 | 2005-05-23 |
| 1740892496 | Stella Monday Wangai | Nurse Practitioner | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-22 |
| 1144832932 | Sonya Wali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-21 |
| 1023620358 | Chrystina Mildred Kiwan | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1518579838 | Alicia Kovach | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-18 |
| 1861003659 | Riyashat Kazmi | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-13 |
| 1114537610 | Kalee Larsen | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-09 |
| 1215547567 | Nirav Patel | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-08-02 |
| 1720697238 | Sneha Bijoy | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
| 1407465891 | Ruhma Ali | Student in an Organized Health Care Education/Training Program | 111 Central Ave, Newark, NJ 07102-1909 | 2020-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487253779 | Integrity, Inc | Clinic/Center | 1091-1093 Broad Street, Newark, NJ 07102 | 2020-10-19 |
| 1881292720 | Oluwaseun Ademulegun | Pharmacist | 1084 Broad Street, Newark, Newark, NJ 07102 | 2020-10-13 |
| 1679042295 | Henry Paul Grayner | Specialist/Technologist | 100 Lock St, Newark, NJ 07102 | 2018-11-14 |
| 1548736838 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 101 Lincoln Park, 2nd Floor, Newark, NJ 07102 | 2018-10-15 |
| 1962981407 | Crystal Kay-baune Mccown | Social Worker | 130 Orange St, Newark, NJ 07102 | 2018-08-07 |
| 1053808865 | Nubi Consultants Corp. Dba Aplus Home Care | Physical Therapist | 11 Franklin Street, 11 Franklin Street, Newark, NJ 07102 | 2018-04-17 |
| 1396249264 | Integrity, Inc | Substance Abuse Rehabilitation Facility | 49 Lincoln Park, Newark, NJ 07102 | 2018-03-23 |
| 1568960896 | Saint James Health Inc | Clinic/Center | 36 Halsey Street, Newark, NJ 07102 | 2018-02-01 |
| 1992216527 | Metropolitan Center for Human Services | Psychologist | 520 Dr. Martin Luther King, Jr. Boulevard, Newark, NJ 07102 | 2017-10-23 |
| 1467974949 | Ahmad Mohammad Tawfiq Damati | Student in an Organized Health Care Education/Training Program | 123 University Ave, Newark, Nj 07102, Newark, NJ 07102 | 2017-07-17 |
| Find all providers in zip 07102 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205218757 | Markian Yuriy Pazuniak | Psychiatry & Neurology | 4755 Ogletown Stanton Rd Ste 116, Newark, DE 19718-2200 | 2015-06-22 |
| 1699970608 | Family & Youth Institute | Psychiatry & Neurology | 14 Sandalwood Drive, Newark, OH 43055 | 2007-06-19 |
| 1972845410 | Tenzing Yangchen | Psychiatry & Neurology | 183 S Orange Ave, Newark, NJ 07103 | 2013-03-22 |
| 1003127101 | Ayesha Silman | Psychiatry & Neurology | 100 Rockford Dr, Newark, DE 19713-2120 | 2010-06-23 |
| 1275869612 | Jessica Elizabeth Shabo | Psychiatry & Neurology | 183 South Orange Ave, Bhsb E-1447 Psychiatry Department, Newark, NJ 07101-1709 | 2009-10-20 |
| 1194982900 | Cecilia Del Carmen Belardinelli | Psychiatry & Neurology | 183 S Orange Ave, Newark, NJ 07103-2757 | 2008-05-20 |
| 1578574919 | Charles W Snyder | Psychiatry & Neurology | 1445 W Main St, Newark, OH 43055-1989 | 2006-08-11 |
| 1679583272 | University Physician Associates of New Jersey Inc | Psychiatry & Neurology | 30 Bergen Street, Admc 12 1205, Newark, NJ 07107-3000 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059079 | Rr & C Associates | Psychiatry & Neurology | 705 Birchfield Dr, Mount Laurel, NJ 08054-4013 | 2019-12-09 |
| 1154888162 | St. Luke's Counseling Medical Center L.L.C. | Psychiatry & Neurology | 59 Seeley Ave, Kearny, NJ 07032-3120 | 2019-02-26 |
| 1194297614 | Childpsych Services, LLC | Psychiatry & Neurology | 940 Cedar Bridge Ave Fl 2, Brick, NJ 08723-4170 | 2018-12-21 |
| 1003279308 | Medisol, LLC | Psychiatry & Neurology | 226 Fisher Ave, Piscataway, NJ 08854-4833 | 2016-04-04 |
| 1043637465 | Jason Dean | Psychiatry & Neurology | 400 Frank W Burr Blvd # 6, Teaneck, NJ 07666-6839 | 2014-03-24 |
| 1184963837 | Prospect Psychiatric Services Limited Liability Company | Psychiatry & Neurology | 344 Prospect Ave Apt 1a, Hackensack, NJ 07601-2602 | 2013-01-31 |
| 1174870034 | Naomi Ambalu | Psychiatry & Neurology | 266 King George Rd Ste G, Warren, NJ 07059-5187 | 2012-08-10 |
| 1699022558 | Nanda Muthusawmy | Psychiatry & Neurology | 210 Malapardis Rd Ste 205, Cedar Knolls, NJ 07927 | 2012-08-10 |
| 1144512674 | Magalie Saint-lot Jacques | Psychiatry & Neurology | 31 Bridgewater Ct, Jackson, NJ 08527-4030 | 2011-05-03 |
| 1043501265 | Kathreen Tharwat Tadrous | Psychiatry & Neurology | 655 E. Jersey Sreet, Trinitas Regional Medical Center, Elizabeth, NJ 07206 | 2011-04-21 |
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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.