Healthcare Provider Details

I. General information

NPI: 1033426291
Provider Name (Legal Business Name): NJ HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 SUMMIT AVE
JERSEY CITY NJ
07306-2702
US

IV. Provider business mailing address

PO BOX 6440
JERSEY CITY NJ
07306-0440
US

V. Phone/Fax

Practice location:
  • Phone: 201-653-0022
  • Fax: 201-653-0443
Mailing address:
  • Phone: 201-653-0022
  • Fax: 201-653-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSSIE E CARPIO
Title or Position: ADMINISTRATOR
Credential:
Phone: 201-653-0022