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General NPI Number Information
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NPI Number | 1003850488
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 427-429 SOUTH MAIN STREET
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865
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Country | US
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Telephone | 908-454-4600
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Fax | 908-454-3619
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Provider Business Mailing Address
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Address Line | 1700-58 MYRTLE AVENUE
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City | PLAINFIELD
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State | NJ
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Zip | 07063
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Country | US
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Telephone | 908-753-6401
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Fax | 908-753-6278
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Authorized Official
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Title or Position | VICE PRESIDENT & COO
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Name | MR. DERRICK C. WILLIAMS
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Credential |
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Telephone | 908-753-6401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA5775700
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA04375900
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 24078
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License Number State | NJ
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