Provider Demographics
NPI:1548447881
Name:GENPSYCH, INC
Entity type:Organization
Organization Name:GENPSYCH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:ODUNLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-526-8370
Mailing Address - Street 1:380 FOOTHILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2255
Mailing Address - Country:US
Mailing Address - Phone:908-526-8370
Mailing Address - Fax:908-526-8722
Practice Address - Street 1:380 FOOTHILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2255
Practice Address - Country:US
Practice Address - Phone:908-231-0511
Practice Address - Fax:908-231-1115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA072910002084P0800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9010106Medicaid
NJ121317Medicare UPIN