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NPI 1003780875

NPI 1003780875 : HAPPY HEALTH OF NEW JERSEY PC : SAINT PAUL, MN

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General NPI Number Information
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    NPI Number           |    1003780875
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    Entity Type          |    Organization 
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    Legal Business Name  |    HAPPY HEALTH OF NEW JERSEY PC 
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Dates
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    Enumeration Date     |    10/03/2025
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    Last Update Date     |    10/03/2025
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Provider Practice Location Address
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    Address Line         |    1385 PHALEN BLVD 
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    City                 |    SAINT PAUL
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    State                |    MN
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    Zip                  |    55106-2126
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    Country              |    US
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    Telephone            |    512-866-1812
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1385 PHALEN BLVD 
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    City                 |    SAINT PAUL
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    State                |    MN
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    Zip                  |    55106-2126
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    Country              |    US
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    Telephone            |    512-866-1812
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SR DIRECTOR OF CLINICAL OPERATIONS
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    Name                 |     CONNOR L WALSH 
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    Credential           |    
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    Telephone            |    845-821-4574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM1300X
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    Taxonomy Name        |    Multi-Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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