1194197087 NPI number — THE ARC OF BERGEN AND PASSAIC COUNTIES, INC.

Table of content: DESMOND BYRON JAY MD (NPI 1720138100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194197087 NPI number — THE ARC OF BERGEN AND PASSAIC COUNTIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ARC OF BERGEN AND PASSAIC COUNTIES, 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:
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:
1194197087
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 PAUL KOHNER PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELMWOOD PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07407-2614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-343-0322
Provider Business Mailing Address Fax Number:
201-343-0401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 PAUL KOHNER PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELMWOOD PARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07407-2614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-343-0322
Provider Business Practice Location Address Fax Number:
201-343-0401
Provider Enumeration Date:
10/30/2015

Additional Information

Authorized Official

Authorized Official Last Name:
WALSH
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
201-343-0322

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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