Provider Demographics
NPI:1134559156
Name:SAINT GEORGE BEHAVIORAL CARE INC
Entity type:Organization
Organization Name:SAINT GEORGE BEHAVIORAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:MITRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-381-5700
Mailing Address - Street 1:2366 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2125
Mailing Address - Country:US
Mailing Address - Phone:732-381-5700
Mailing Address - Fax:732-381-5827
Practice Address - Street 1:2366 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2125
Practice Address - Country:US
Practice Address - Phone:732-381-5700
Practice Address - Fax:732-381-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086017Medicare PIN