Healthcare Provider Details
I. General information
NPI: 1215557954
Provider Name (Legal Business Name): NJ BIRTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/23/2020
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
405 CEDAR LN REAR STE 102
TEANECK NJ
07666-1739
US
IV. Provider business mailing address
163 CARLTON TER
TEANECK NJ
07666-4618
US
V. Phone/Fax
- Phone: 973-981-0248
- Fax: 202-353-2589
- Phone: 973-981-0248
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QB0400X |
| Taxonomy | Birthing Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MR.
DAVID
J
BILDNER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 973-981-0248