Initia Nova LLC

Specialist · Cherry Hill, NJ

Organization Active NPI

NPI number 1013461243

Practice location

1930 Marlton Pike E Ste H42
Cherry Hill, NJ 08003-4104
Phone
(856) 425-2942

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NPI record

NPI
1013461243
Entity type
Organization (Type 2)
Enumeration date
August 4, 2016
Last updated
August 4, 2016
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Specialist Primary 174400000X — NJ
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 37F100176500 NJ

Authorized official

Name
Dr. Patrick O Sullivan, D.O.
Title
Chief Medical Officer
Phone
(856) 625-8563

About Initia Nova LLC

Initia Nova LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Specialist (code 174400000X). The practice location is 1930 Marlton Pike E Ste H42, Cherry Hill, NJ 08003-4104. The NPI number 1013461243 was assigned on August 4, 2016 and the record was last updated on August 4, 2016.

Initia Nova LLC lists a license in the registry: #37F100176500 (NJ) for Mental Health Clinic/Center (Including Community Mental Health Center). License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Patrick O Sullivan, D.O., Chief Medical Officer.

Frequently asked questions

What is the NPI number of Initia Nova LLC?

The NPI number is 1013461243.

What is the phone number of Initia Nova LLC?

The phone number listed for the practice location is (856) 425-2942.

Where is Initia Nova LLC located?

1930 Marlton Pike E Ste H42, Cherry Hill, NJ 08003-4104.

What is the taxonomy code for Initia Nova LLC?

The primary taxonomy code is 174400000X – Specialist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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