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NPI Code Detail

MEDICARE: JEWISH FAMILY SERVICE & CHILDREN'S CENTER OF CLIFTON/PASSAIC, INC.

MEDICARE: JEWISH FAMILY SERVICE & CHILDREN'S CENTER OF CLIFTON/PASSAIC, INC.
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
11041C0700XClinical Social WorkerSC06729NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15857712OTHERNJAETAN GROUP ID
2G434928OTHERNJOXFORD GROUP ID
3205038OTHERNJMHN GROUP ID
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5145803 000OTHERNJMAGELLAN BEHAVIORAL HEALT
62021541OTHERCIGNA (GROUP ID)

General Provider Information

NPI Number : 1457385700
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWISH FAMILY SERVICE & CHILDREN'S CENTER OF CLIFTON/PASSAIC, INC.
Provider Business Mailing Address
First Line : 110 MAIN AVE
Second Line :
City : PASSAIC
State : NJ
Zip : 07055-4427
Country : US
Telephone Number : 973-777-7638
Fax Number : 973-777-9311
Provider Business Practice Location Address
First Line : 110 MAIN AVE
Second Line :
City : PASSAIC
State : NJ
Zip : 07055-4427
Country : US
Telephone Number : 973-777-7638
Fax Number : 973-777-9311
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : ALEXANDER HERZOG
Credential : LCSW
Telephone Number : 973-777-7638
Provider Enumeration Date : 07/11/2006
Last Update Date : 05/02/2023

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Directions to “JEWISH FAMILY SERVICE & CHILDREN'S CENTER OF CLIFTON/PASSAIC, INC. ” Practice Location

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