1679824528 NPI number — ABILITIES OF NORTHWEST JERSEY, 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 1679824528 NPI number — ABILITIES OF NORTHWEST JERSEY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABILITIES OF NORTHWEST JERSEY, 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:
1679824528
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 251
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07882-0251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
264 STATE ROUTE 31 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07882-1550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-689-1118
Provider Business Practice Location Address Fax Number:
908-689-6363
Provider Enumeration Date:
10/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WILDERMUTH
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
B
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
908-689-1118

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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