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General NPI Number Information
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NPI Number | 1942749429
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Entity Type | Organization
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Legal Business Name | NORTHWEST ESSEX COMMUNITY HEALTHCARE
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 570 BELLEVILLE AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-1308
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Country | US
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Telephone | 973-450-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 570 BELLEVILLE AVENUE
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City | BELLEVILLE
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State | NJ
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Zip | 07109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | VIONIA HAGEMAN
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Credential |
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Telephone | 973-450-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 30202
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License Number State | NJ
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