Prov 205 Llc - Mental Health Clinic in Bayonne, NJ

Prov 205 Llc is a mental health clinic (Psychologist) in Bayonne, New Jersey. The current practice location for Prov 205 Llc is 866 Broadway, Suite A, Bayonne, New Jersey. For appointments, you can reach them via phone at (201) 455-2052. The mailing address for Prov 205 Llc is Po Box 626, New Providence, New Jersey and phone number is (201) 455-2052.

Prov 205 Llc is licensed to practice in New Jersey (license number 35SI00437200) and its NPI number is 1063963411. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (201) 455-2052.

Contact Information

Prov 205 Llc
866 Broadway
Suite A
Bayonne
NJ 07002-3070
(201) 455-2052
(201) 354-9376

Mental Health Clinic Profile

Full NameProv 205 Llc
SpecialityPsychologist
Location866 Broadway, Bayonne, New Jersey
Authorized Official Name and PositionJoel Nunez (PSYCHOLOGIST)
Authorized Official Contact2014552052
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Prov 205 Llc
Po Box 626
New Providence
NJ 07974-0626

Ph: (201) 455-2052
Prov 205 Llc
866 Broadway
Suite A
Bayonne
NJ 07002-3070

Ph: (201) 455-2052

NPI Details:

NPI Number1063963411
Provider Enumeration Date10/20/2016
Last Update Date04/27/2017

Medical Identifiers

Medical identifiers for Prov 205 Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063963411NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 35SI00437200 (New Jersey)Primary

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› Verified 7 days ago

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