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1134857642
MINDSPACE CLINIC
EAST ORANGE, NJ
NPI
1134857642
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Entity Type
Organization
Authorized Contact
LILIAN KORDIE
Provider
201-407-0702
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2022-08-11
Last Update Date
2022-08-11
Business Address
MINDSPACE CLINIC
137 EVEGREEN PLACE SUITE 1B
EAST ORANGE, NJ 07018-2005
Phone number: 201-407-0702
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Mailing Address
MINDSPACE CLINIC
137 EVEGREEN PLACE
EAST ORANGE, NJ 07018-2005
Phone number: 201-407-0702
Copy
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