1023235454 NPI number — ARISTA BEHAVIORAL HEALTH

Table of content: (NPI 1023235454)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023235454 NPI number — ARISTA BEHAVIORAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARISTA BEHAVIORAL HEALTH
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:
Provider Other Organization Name Type Code:
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:
1023235454
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:
12 ROUTE 17 NORTH
Provider Second Line Business Mailing Address:
SUITE 313
Provider Business Mailing Address City Name:
PARAMUS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07652
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-368-3700
Provider Business Mailing Address Fax Number:
201-368-0055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 ROUTE 17 NORTH
Provider Second Line Business Practice Location Address:
SUITE 313
Provider Business Practice Location Address City Name:
PARAMUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-368-3700
Provider Business Practice Location Address Fax Number:
201-368-0055
Provider Enumeration Date:
04/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GURFEIN
Authorized Official First Name:
HADASSAH
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
201-368-3700

Provider Taxonomy Codes

  • Taxonomy code: 102L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103TB0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103TF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 103TP0814X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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