1548272420 NPI number — PATRICIA H. KING LCSW

Table of content: PATRICIA H. KING LCSW (NPI 1548272420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548272420 NPI number — PATRICIA H. KING LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KING
Provider First Name:
PATRICIA
Provider Middle Name:
H.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOROWITZ KING
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1548272420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
199 SCOLES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07012-1125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-777-7638
Provider Business Mailing Address Fax Number:
973-777-9311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
199 SCOLES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07012-1125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-777-7638
Provider Business Practice Location Address Fax Number:
973-777-9311
Provider Enumeration Date:
08/12/2006

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:  44SC00529100 , 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: 7349644 . This is a "GHI ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P-434931 . This is a "OXFORD ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 270257 . This is a "MHN ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0021784 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 109255 . This is a "VALUE OPTION" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7840351 . This is a "AETNA ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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