Healthcare Provider Details

I. General information

NPI: 1295317808
Provider Name (Legal Business Name): HEALTHY PEOPLE WORLDWIDE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 VALLEY RD UNIT 2594
CLIFTON NJ
07013-1319
US

IV. Provider business mailing address

62 CADMUS AVE APT LEFT
ELMWOOD PARK NJ
07407-2505
US

V. Phone/Fax

Practice location:
  • Phone: 609-900-7883
  • Fax:
Mailing address:
  • Phone: 813-360-7277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VANESSA EZEMADU
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 609-900-7883