Basic Information
| Provider Information | |||||||||
| NPI: | 1700469160 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TMS CLINICAL SERVICES OF NEW JERSEY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 JORIE BLVD STE 172 | ||||||||
| Address2: | |||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605234409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2247778034 | ||||||||
| FaxNumber: | 2242364700 | ||||||||
| Practice Location | |||||||||
| Address1: | 161 WASHINGTON VALLEY RD STE 207 | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070597177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309746602 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2021 | ||||||||
| LastUpdateDate: | 06/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | SAN JUAN | ||||||||
| AuthorizedOfficialFirstName: | RACQUEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2247778034 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 06/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.