1548769797 NPI number — DAYTOP VILLAGE OF NEW JERSEY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548769797 NPI number — DAYTOP VILLAGE OF NEW JERSEY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAYTOP VILLAGE OF NEW JERSEY, 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:
1548769797
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENDHAM
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07945-0310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
862-260-9460
Provider Business Mailing Address Fax Number:
862-260-9461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 HARDING HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSGROVE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08318-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-358-4111
Provider Business Practice Location Address Fax Number:
856-358-4120
Provider Enumeration Date:
02/02/2018

Additional Information

Authorized Official

Authorized Official Last Name:
SOSELY
Authorized Official First Name:
JANET
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
AR MANAGER
Authorized Official Telephone Number:
862-260-9460

Provider Taxonomy Codes

  • Taxonomy code: 323P00000X , 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)





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