Healthcare Provider Details

I. General information

NPI: 1548666407
Provider Name (Legal Business Name): NEW AVENUES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 HILLCREST DR
GREAT MEADOWS NJ
07838-2212
US

IV. Provider business mailing address

63 HILLCREST DR
GREAT MEADOWS NJ
07838-2212
US

V. Phone/Fax

Practice location:
  • Phone: 908-914-6337
  • Fax:
Mailing address:
  • Phone: 908-914-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. HASSAN J FARHAN
Title or Position: GENERAL MANAGER
Credential:
Phone: 908-914-6337