Peruo, Colleen M
Peruo, Colleen M is an sole proprietor health care provider with primary practice located at 1314 Broad St , Clifton NJ 07013-4220. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Peruo, Colleen M can be contacted via phone (973) 779-1107.Contact Information
Primary practice address
1314 Broad St
Clifton NJ 07013-4220
Phone: (973) 779-1107
Fax: (973) 779-4555
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | SI3181 | New Jersey |
Profile Details
NPI number | 1275696320 |
---|---|
LBN Legal business name | Peruo, Colleen M |
Credentials | Certified Psychologist (CP) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 19th, 2006 |
Last updated | Feb 24th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1275696320 | NPPES |
New Jersey | MEDICAID | 6260306 |
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