Portum Private Practice LLC
Portum Private Practice LLC is a Clinical Child & Adolescent Psychologist in Annandale, New Jersey. Registered with an NPI since 2024.
- In the registry since
- 2024
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1465 Route 31 SAnnandale, NJ 08801-3129
Phone: (732) 614-0994
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Child & Adolescent Psychologist (primary) | Taxonomy 103TC2200X |
|---|---|
| Child & Adolescent Psychiatry Physician | Taxonomy 2084P0804X |
Record details
| NPI number | 1528802568 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Decker — Coo · (732) 614-0994 |
| NPI enumerated | June 24, 2024 |
| Last updated in NPPES | June 24, 2024 |
| Certification date | June 24, 2024 |
| Mailing address | 1465 Route 31 S, Annandale, NJ 08801-3129 |