Healthcare Provider Details

I. General information

NPI: 1912006560
Provider Name (Legal Business Name): A&T HEALTHCARE OF NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 MAIN ST
HACKENSACK NJ
07601-7135
US

IV. Provider business mailing address

144 MAIN ST
HACKENSACK NJ
07601-7135
US

V. Phone/Fax

Practice location:
  • Phone: 845-638-4342
  • Fax: 845-638-1303
Mailing address:
  • Phone: 845-638-4342
  • Fax: 845-638-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0069800
License Number StateNJ

VII. Legacy identifiers

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

# 1
Identifier0094102
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MRS. TONI BABINGTON
Title or Position: PRESIDENT
Credential:
Phone: 845-638-4342