1871707109 NPI number — UNITED PROGRESS, 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 1871707109 NPI number — UNITED PROGRESS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED PROGRESS, 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:
1871707109
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
162 W STATE ST
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08601-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-392-2161
Provider Business Mailing Address Fax Number:
609-392-2166

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
56 ESCHER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08609-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-392-2822
Provider Business Practice Location Address Fax Number:
609-392-3215
Provider Enumeration Date:
05/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DONA
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
609-392-2161

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , 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: 7706502 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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