Healthcare Provider Details

I. General information

NPI: 1881148526
Provider Name (Legal Business Name): PHG SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 SUMMIT AVE
HACKENSACK NJ
07601-1429
US

IV. Provider business mailing address

331 SUMMIT AVE
HACKENSACK NJ
07601-1429
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-0408
  • Fax: 201-488-0411
Mailing address:
  • Phone: 201-488-0408
  • Fax: 201-488-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05342100
License Number StateNJ

VIII. Authorized Official

Name: SARAH GLISKY
Title or Position: OWNER
Credential:
Phone: 201-488-0408