Healthcare Provider Details

I. General information

NPI: 1265350417
Provider Name (Legal Business Name): WINSTATE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 BROAD ST
THREE BRIDGES NJ
08887-9800
US

IV. Provider business mailing address

PO BOX 22
THREE BRIDGES NJ
08887-0022
US

V. Phone/Fax

Practice location:
  • Phone: 908-318-4002
  • Fax:
Mailing address:
  • Phone: 908-318-4002
  • 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: TAORIDI KASSIM
Title or Position: SERVICES DIRECTOR
Credential:
Phone: 908-318-4002