1851390546 NPI number — CARE ONE AT PARSIPPANY TROY HILLS, LLC

Table of content: (NPI 1851390546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851390546 NPI number — CARE ONE AT PARSIPPANY TROY HILLS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE ONE AT PARSIPPANY TROY HILLS, LLC
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:
CARE ONE AT MORRIS
Provider Other Organization Name Type Code:
3
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:
1851390546
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MAZDABROOK ROAD PARSIPPANY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY HILLS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-952-5300
Provider Business Mailing Address Fax Number:
973-739-9051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MAZDABROOK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSIPPANY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07054-3304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-739-9494
Provider Business Practice Location Address Fax Number:
973-739-9051
Provider Enumeration Date:
07/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LUGO
Authorized Official First Name:
A.
Authorized Official Middle Name:
ALBERTO
Authorized Official Title or Position:
EXECUTIVE VP & GENERAL COUNSEL
Authorized Official Telephone Number:
201-242-4000

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , 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: 9081704 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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