Healthcare Provider Details

I. General information

NPI: 1982723896
Provider Name (Legal Business Name): JEWISH FAMILY SERVICE OF CENTRAL NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 WESTFIELD AVE
ELIZABETH NJ
07208-1325
US

IV. Provider business mailing address

227 N EIGHTH AVE
EDISON NJ
08817-2912
US

V. Phone/Fax

Practice location:
  • Phone: 908-352-8375
  • Fax:
Mailing address:
  • Phone: 732-572-4045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number33SL04705600
License Number StateNJ

VIII. Authorized Official

Name: MS. SHARON R. CHESIR
Title or Position: CASE MANGER
Credential: LSW
Phone: 908-352-8375