1528065372 NPI number — MS. ANNETTE DINAPOLI LCSW, DCSW

Table of content: BRENDON ISAAC MATSUDA-FONG PHARMD (NPI 1073182960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528065372 NPI number — MS. ANNETTE DINAPOLI LCSW, DCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DINAPOLI
Provider First Name:
ANNETTE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, DCSW
Provider Gender Code:
F

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:
1528065372
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/21/2006
NPI Reactivation Date:
03/27/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 232
Provider Second Line Business Mailing Address:
SUITE #8A
Provider Business Mailing Address City Name:
NEWFOUNDLAND
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07435-0232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-208-8884
Provider Business Mailing Address Fax Number:
973-601-0454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2713 ROUTE 23 SOUTH
Provider Second Line Business Practice Location Address:
SUITE #8A
Provider Business Practice Location Address City Name:
NEWFOUNDLAND
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07435-0232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-208-8884
Provider Business Practice Location Address Fax Number:
973-601-0454
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC00075100 , 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: 104200 . This is a "MENTAL HEALTH NETWORK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: J024934 . This is a "CHAMPUS PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: OK5408 . This is a "PHYSICANS HEALTH SERVICES" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P451839 . This is a "OXFORD INSURANCE PROVIDER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 140000751NJ01 . This is a "ANTHEM HEALTH NETWORK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 35141 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: N1B061 . This is a "EMPIRE B/C B/S PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 039398 . This is a "VALUE OPTIONS PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 44SC00075100 . This is a "LCSW LICENSE NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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