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General NPI Number Information
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NPI Number | 1275877508
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Entity Type | Organization
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Legal Business Name | ATC HEALTHCARE
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 1180 US HIGHWAY 22
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2810
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Country | US
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Telephone | 908-654-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 86 E PROSPECT ST
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City | WALDWICK
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State | NJ
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Zip | 07463-2216
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Country | US
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Telephone | 214-548-8639
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Fax | 201-444-5481
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Authorized Official
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Title or Position | OTR/L
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Name | JOAN E JENSEN
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Credential |
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Telephone | 214-548-8639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 46TR00109300
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License Number State | NJ
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