1043226806 NPI number — V.A.N.J.HEALTHCARE SYSTEM

Table of content: (NPI 1043226806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043226806 NPI number — V.A.N.J.HEALTHCARE SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
V.A.N.J.HEALTHCARE SYSTEM
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:
1043226806
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:
4533 LANDISVILLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOYLESTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18901-1246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-348-1886
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 KNOLLCROFT RD
Provider Second Line Business Practice Location Address:
BLDG. 57
Provider Business Practice Location Address City Name:
LYONS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07939-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-647-0180
Provider Business Practice Location Address Fax Number:
908-604-5850
Provider Enumeration Date:
08/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LISBON
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
WILLARD
Authorized Official Title or Position:
SOCIAL WORKER
Authorized Official Telephone Number:
908-647-0180

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  SW005596E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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