1154314151 NPI number — RIDLEN CONSULTING INC

Table of content: (NPI 1154314151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154314151 NPI number — RIDLEN CONSULTING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIDLEN CONSULTING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HUDSON BEHAVIORAL HEALTH ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154314151
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 SHERMAN PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JERSEY CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07307-3730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-798-5725
Provider Business Mailing Address Fax Number:
201-420-0633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 PAVONIA AVE
Provider Second Line Business Practice Location Address:
3RD FL
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07306-2929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-798-5725
Provider Business Practice Location Address Fax Number:
201-420-0633
Provider Enumeration Date:
08/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RIDLEN
Authorized Official First Name:
SYLVIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
201-798-5725

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC046559 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P2214572 . This is a "OXFORD ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 220819 . This is a "MANAGED HEALTH NETWORK ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com