Healthcare Provider Details

I. General information

NPI: 1174653505
Provider Name (Legal Business Name): 1ST CEREBRAL PALSY OF NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SANFORD AVE
BELLEVILLE NJ
07109-1221
US

IV. Provider business mailing address

7 SANFORD AVE
BELLEVILLE NJ
07109-1221
US

V. Phone/Fax

Practice location:
  • Phone: 973-751-0200
  • Fax:
Mailing address:
  • Phone: 973-751-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: KAREN HUHN
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 973-751-0200