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General NPI Number Information
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NPI Number | 1023955630
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Entity Type | Organization
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Legal Business Name | NEW JERSEY DEVELOPMENTAL SERVICES LLC
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 111 TOWN SQUARE PL STE 1201
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1724
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Country | US
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Telephone | 201-293-8220
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Fax |
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Provider Business Mailing Address
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Address Line | 111 TOWN SQUARE PL STE 1201
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1724
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Country | US
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Telephone | 201-293-8220
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MIRIAM STEIN
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Credential |
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Telephone | 201-293-8220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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