Provider / Organization | NPI | Date Certified |
---|---|---|
JEFFREY DYNOF | 1649948589 | 2021-09-03 |
Jeffrey Dynof is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1649948589. Registration indicates Jeffrey Dynof is a provider of access to mental health/behavioral health providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
Entity Type | Individual |
Provider Name | Dr. Jeffrey Dynof DNP, APN, PMHNP-BC |
Practice Office Address | 221 PARK AVE RUTHERFORD, NJ US |
Practice Office Telephone | 2012930976 |
Mailing Address | 221 PARK AVE RUTHERFORD, NJ 070702309 US |
Address | City / State | Phone / Fax |
---|---|---|
550 Broad St Ste 606 | Newark, NJ 071024537 | 2018221161 / 8774858918 |
Code | Practice | License No State |
---|---|---|
363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 26NJ01195000
NJ |
0817619 | MEDICAID | NJ |