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General NPI Number Information
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NPI Number | 1154654259
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Entity Type | Organization
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Legal Business Name | COMMUNITIES UNITED HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 09/08/2009
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 800 BROAD ST SUITE EDISON PL.
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City | NEWARK
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State | NJ
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Zip | 07102-2760
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Country | US
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Telephone | 973-242-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 39 CLEREMONT AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111-3126
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Country | US
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Telephone | 862-223-6324
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. EDWIN E DUNGA
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Credential | PHD
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Telephone | 862-223-6324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC01301800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 37PC00373000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00426600
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05161500
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License Number State | NJ
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