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Avicenna Medical Group, Llc
Mental Health Counselor in West Orange, New Jersey
NPI 1194067959

Avicenna Medical Group, Llc is a Mental Health Counselor based in West Orange, NJ and is specialized in Mental Health. Avicenna Medical Group, Llc practices in West Orange, NJ. The NPI Number for Avicenna Medical Group, Llc is 1194067959 and holds a License No. 25MB07627000 (New Jersey).

The current practice location address for Avicenna Medical Group, Llc is 414 Eagle Rock Ave, West Orange, NJ and can be reached out via phone at 646-464-3110.

Location: 414 Eagle Rock Ave, West Orange, NJ, 07052-4224
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1194067959
Provider Name
Avicenna Medical Group, Llc
Credential
Provider Entity Type
Organization
Address
414 Eagle Rock Ave, West Orange, NJ, 07052-4224
Phone Number
646-464-3110
Fax Number
Provider Enumeration Date
03/20/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
414 Eagle Rock Ave
City
West Orange
State
New Jersey
Zip
07052-4224
Phone Number
646-464-3110
Fax Number
person
Provider Business Mailing Address Details
Address
414 Eagle Rock Ave
City
West Orange
State
New Jersey
Zip
07052-4224
Phone Number
646-464-3110
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
25MB07627000 (New Jersey)
Definition
Definition to come...
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