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General NPI Number Information
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NPI Number | 1699018242
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Entity Type | Organization
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Legal Business Name | EVA'S VILLAGE, INC.
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 20 JACKSON STREET
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City | PATERSON
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State | NJ
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Zip | 07501-2815
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Country | US
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Telephone | 973-523-6220
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Fax | 973-825-7297
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Provider Business Mailing Address
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Address Line | 393 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07501-2815
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Country | US
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Telephone | 973-523-6220
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Fax | 973-825-7297
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Authorized Official
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Title or Position | CHIEF EXECUTIVE DIRECTOR
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Name | MR. MARK SCHMIT
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Credential |
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Telephone | 973-523-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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