Healthcare Provider Details

I. General information

NPI: 1225755879
Provider Name (Legal Business Name): NATIONAL INSTITUTE FOR PEOPLE WITH DISABILITIES OF NEW JERSEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 WHITNEY RD FL 2
MAHWAH NJ
07430-3160
US

IV. Provider business mailing address

PO BOX 301
ORADELL NJ
07649-0301
US

V. Phone/Fax

Practice location:
  • Phone: 201-750-0509
  • Fax:
Mailing address:
  • Phone: 201-750-0509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RALPH COLOMA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 201-750-0509