Healthcare Provider Details

I. General information

NPI: 1881673564
Provider Name (Legal Business Name): PERSONAL TOUCH HOME CARE OF NJ, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 LIBERTY ST
BLOOMFIELD NJ
07003-2620
US

IV. Provider business mailing address

22215 NORTHERN BLVD
BAYSIDE NY
11361-3603
US

V. Phone/Fax

Practice location:
  • Phone: 973-680-1434
  • Fax: 973-680-1078
Mailing address:
  • Phone: 718-468-4747
  • Fax: 718-264-5834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0022001
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0071609
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: LORIGAY LASKIN
Title or Position: CONTRACT MANAGER
Credential:
Phone: 718-468-4747