Healthcare Provider Details

I. General information

NPI: 1538596903
Provider Name (Legal Business Name): HEART TO HEART & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CLOVERDALE AVE
PARAMUS NJ
07652-2503
US

IV. Provider business mailing address

111 CLOVERDALE AVE
PARAMUS NJ
07652-2503
US

V. Phone/Fax

Practice location:
  • Phone: 201-538-0519
  • Fax:
Mailing address:
  • Phone: 201-538-0519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0400601835
License Number StateNJ

VII. Legacy identifiers

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

VIII. Authorized Official

Name: PATRICIA SCORNAVACCA
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 201-538-0519