Healthcare Provider Details

I. General information

NPI: 1881464170
Provider Name (Legal Business Name): CUDDLECARE FC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 BRADHURST AVE # A
LAKEWOOD NJ
08701-6135
US

IV. Provider business mailing address

1321 GEORGIAN TER
LAKEWOOD NJ
08701-1641
US

V. Phone/Fax

Practice location:
  • Phone: 848-261-2920
  • Fax:
Mailing address:
  • Phone: 848-261-2920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. NOSSON CENSOR
Title or Position: CEO
Credential:
Phone: 848-261-2920