1952708828 NPI number — SKJ HEALTH ENTERPRISES INC.

Table of content: ELIZABETH ALANA PUMIGLIA CRNP (NPI 1033818802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952708828 NPI number — SKJ HEALTH ENTERPRISES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SKJ HEALTH ENTERPRISES 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:
6
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:
1952708828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 APPLE ST
Provider Second Line Business Mailing Address:
SUITE 113
Provider Business Mailing Address City Name:
TINTON FALLS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07724-2669
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-272-0222
Provider Business Mailing Address Fax Number:
732-587-6606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 APPLE ST
Provider Second Line Business Practice Location Address:
SUITE 113
Provider Business Practice Location Address City Name:
TINTON FALLS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07724-2669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-272-0222
Provider Business Practice Location Address Fax Number:
732-587-6606
Provider Enumeration Date:
11/20/2014

Additional Information

Authorized Official

Authorized Official Last Name:
STICKLER
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-272-0222

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  HP0193100 , 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: HP0193100 . This is a "NJ OFFICE OF THE ATTORNEY GENERAL - DIVISION OF CONSUMER AFFAIRS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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