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NPI Code Detail

MEDICARE: NEIGHBORHOOD HEALTH SERVICES CORPORATION

MEDICARE: NEIGHBORHOOD HEALTH SERVICES CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist
2207R00000XInternal Medicine Physician
3207V00000XObstetrics & Gynecology Physician
4208000000XPediatrics Physician
5207R00000XInternal Medicine PhysicianNJ
6208000000XPediatrics PhysicianNJ
7261QF0400XFederally Qualified Health Center (FQHC)22271NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316981707
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEIGHBORHOOD HEALTH SERVICES CORPORATION
Provider Business Mailing Address
First Line : 1700-58 MYRTLE AVENUE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063
Country : US
Telephone Number : 908-753-6401
Fax Number : 908-753-8278
Provider Business Practice Location Address
First Line : 1700-58 MYRTLE AVENUE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063
Country : US
Telephone Number : 908-753-6401
Fax Number : 908-753-6278
Authorized Official
Title or Position : VICE PRESIDENT & COO
Name : MR. DERRICK C. WILLIAMS
Credential :
Telephone Number : 908-753-6401
Provider Enumeration Date : 06/15/2006
Last Update Date : 10/27/2015

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Directions to “NEIGHBORHOOD HEALTH SERVICES CORPORATION ” Practice Location

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