Healthcare Provider Details

I. General information

NPI: 1801154539
Provider Name (Legal Business Name): PEER & CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 HACKENSACK AVE
HACKENSACK NJ
07601-6328
US

IV. Provider business mailing address

411 HACKENSACK AVE
HACKENSACK NJ
07601-6328
US

V. Phone/Fax

Practice location:
  • Phone: 201-500-7894
  • Fax:
Mailing address:
  • Phone: 201-500-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. ISRAEL KRASUZ
Title or Position: PRESIDENT
Credential:
Phone: 201-500-7894