BLOOMFIELD HEALTH PAVILION LLC NPI 1598781973

NPI Information

  • NPI: 1598781973
  • Provider Name: BLOOMFIELD HEALTH PAVILION LLC
  • Classification: Psychologist - 103TA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 86 BLOOMFIELD AVE
    1ST FLOOR & BASEMENT
    NEWARK, NJ
    ZIP 07104
  • Phone: (973) 230-3631

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NPI Details

BLOOMFIELD HEALTH PAVILION LLC is an addiction (substance use disorder) psychologist in Newark, NJ. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. BLOOMFIELD HEALTH PAVILION LLC NPI is 1598781973. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

86 BLOOMFIELD AVE
1ST FLOOR & BASEMENT
NEWARK, NJ
ZIP 07104-905
Phone: (973) 230-3631
Fax: (973) 230-3474

The provider's authorized official is Rostislav Vilshteyn .
The authorized official title is Ceo and has the following contact phone number (718) 813-4556.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)051A267NEW JERSEYYes
2103TA0700XPsychologistAdult Development & Aging051A267NEW JERSEYX
3103TB0200XPsychologistCognitive & Behavioral051A267NEW JERSEYX
4103TC1900XPsychologistCounseling051A267NEW JERSEYX
5103TC2200XPsychologistClinical Child & Adolescent051A267NEW JERSEYX
6103T00000XPsychologist051A267NEW JERSEYX
7103TP2701XPsychologistGroup Psychotherapy051A267NEW JERSEYX
8103TR0400XPsychologistRehabilitation051A267NEW JERSEYX
9363L00000XNurse PractitionerNEW JERSEYX
10363LC1500XNurse PractitionerCommunity HealthNEW JERSEYX
11363LP2300XNurse PractitionerPrimary CareNEW JERSEYX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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