Provider Demographics
NPI:1275418915
Name:BACK TO NEUTRAL
Entity type:Organization
Organization Name:BACK TO NEUTRAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FAMIGIETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-687-5630
Mailing Address - Street 1:500 PATERSON PLANK RD STE 31046
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-3416
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 PATERSON PLANK RD STE 31046
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3416
Practice Address - Country:US
Practice Address - Phone:732-687-5630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health