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FIRST CHOICE RECOVERY CENTER PC NPI 1962071910


NPI Information

NPI: 1962071910
Provider Name: FIRST CHOICE RECOVERY CENTER PC
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 31D2244941

Address:
61 N MAPLE AVE STE 302
RIDGEWOOD, NJ
ZIP 07450
Phone: (201) 956-9483
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FIRST CHOICE RECOVERY CENTER PC is an addiction (substance use disorder) psychologist in Ridgewood, NJ. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. FIRST CHOICE RECOVERY CENTER PC NPI is 1962071910. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

61 N MAPLE AVE STE 302
RIDGEWOOD, NJ
ZIP 07450-232
Phone: (201) 956-9483
Fax: (201) 288-5262

The provider's authorized official is Manoj Puthiyathu .
The authorized official title is Owner and has the following contact phone number (201) 956-9483.

The CLIA number assigned to this NPI record is 31D2244941 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2021 and was last updated on 6/23/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
125MA09523700OTHERNEW JERSEYSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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