1730431933 NPI number — THE CENTER FOR FAMILY SUPPORT, 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 1730431933 NPI number — THE CENTER FOR FAMILY SUPPORT, NEW JERSEY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CENTER FOR FAMILY SUPPORT, 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:
1730431933
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 ROBIN RD
Provider Second Line Business Mailing Address:
SUITE 122
Provider Business Mailing Address City Name:
PARAMUS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07652-1449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-262-4021
Provider Business Mailing Address Fax Number:
201-262-0260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 ROBIN RD
Provider Second Line Business Practice Location Address:
SUITE 122
Provider Business Practice Location Address City Name:
PARAMUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07652-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-262-4021
Provider Business Practice Location Address Fax Number:
201-262-0260
Provider Enumeration Date:
10/11/2012

Additional Information

Authorized Official

Authorized Official Last Name:
VERNIKOFF
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
212-629-7939

Provider Taxonomy Codes

  • Taxonomy code: 261QD1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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