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General NPI Number Information
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NPI Number | 1588333934
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Entity Type | Organization
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Legal Business Name | 1ST CEREBRAL PALSY OF NEW JERSEY
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 9 SANFORD AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-1221
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Country | US
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Telephone | 973-751-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 7 SANFORD AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-1221
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Country | US
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Telephone | 973-751-0200
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Fax | 973-751-4635
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PATRICK DENIS COLLIGAN
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Credential | MPA
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Telephone | 973-751-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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