1376939199 NPI number — BLESSED FAMILY CARE CONSULTANTS LLC

Table of content: (NPI 1376939199)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376939199 NPI number — BLESSED FAMILY CARE CONSULTANTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLESSED FAMILY CARE CONSULTANTS 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:
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:
1376939199
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
146 STUYVESANT AVE
Provider Second Line Business Mailing Address:
FLOOR 2
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07106-2508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
862-576-2061
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 UNION AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
IRVINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07111-3219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
862-217-4480
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2015

Additional Information

Authorized Official

Authorized Official Last Name:
FADIPE
Authorized Official First Name:
BOLA
Authorized Official Middle Name:
Authorized Official Title or Position:
FAMILY NURSE PRACTITIONER
Authorized Official Telephone Number:
862-576-2061

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  26NJ00468500 , 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)





Copyright © 2007-2025 www.npivalidator.com