Healthcare Provider Details

I. General information

NPI: 1982457941
Provider Name (Legal Business Name): NPHEALTHNOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

786 KING GEORGE RD STE 1
FORDS NJ
08863-1981
US

IV. Provider business mailing address

81 WATCHUNG AVE
WEST ORANGE NJ
07052-6006
US

V. Phone/Fax

Practice location:
  • Phone: 201-528-3513
  • Fax:
Mailing address:
  • Phone: 862-252-3805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACYANN ANDERSON
Title or Position: NURSE PRACTITIONER
Credential: APN
Phone: 862-252-3805