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General NPI Number Information
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NPI Number | 1114517513
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Entity Type | Organization
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Legal Business Name | SKILLZ OF NEW JERSEY
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 347 E RAILWAY AVE FL 2
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City | PATERSON
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State | NJ
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Zip | 07503-1217
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Country | US
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Telephone | 973-653-9974
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Fax |
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Provider Business Mailing Address
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Address Line | 161 E 9TH ST
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City | CLIFTON
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State | NJ
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Zip | 07011-1773
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Country | US
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Telephone | 201-321-2855
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAREK ALNATUR
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Credential |
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Telephone | 201-321-2855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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