Healthcare Provider Details

I. General information

NPI: 1548085863
Provider Name (Legal Business Name): SANMAR CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 CHAMBERLAIN AVE STE 5
PATERSON NJ
07522-1000
US

IV. Provider business mailing address

470 CHAMBERLAIN AVE STE 5
PATERSON NJ
07522-1000
US

V. Phone/Fax

Practice location:
  • Phone: 973-652-5740
  • Fax:
Mailing address:
  • Phone: 973-652-5740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. REGANA BRACEY
Title or Position: DIRECTOR
Credential: MPS
Phone: 973-652-5740