MEDICARE: SOUTH HACKENSACK

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
1	251300000X	Local Education Agency (LEA)	251300000X	NJ

General Provider Information

NPI Number	:	1518134360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH HACKENSACK

Provider Business Mailing Address
First Line	:	1 DYER AVE
Second Line	:
City	:	SOUTH HACKENSACK
State	:	NJ
Zip	:	07606-1537
Country	:	US
Telephone Number	:	201-440-2782
Fax Number	:	201-440-9156

Provider Business Practice Location Address
First Line	:	1 DYER AVE
Second Line	:
City	:	SOUTH HACKENSACK
State	:	NJ
Zip	:	07606-1537
Country	:	US
Telephone Number	:	201-440-2782
Fax Number	:	201-440-9156

Authorized Official
Title or Position	:	CHIEF SCHOOL ADMINISTRATOR
Name	:	DR. WILLIAM DEFABIIS
Credential	:	ED.D.
Telephone Number	:	201-440-2782

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	05/12/2008

Similar Medicare Providers

1104808518 — DR. DENNIS MIN D.O.
Practice Location Address:

1537 SOUTH BREIEL BOULEVARD
MIDDLETOWN, OH
45044-6703

Practice Phone: 513-425-8300
Practice Fax: 513-425-8301

1013999424 — PREMIER GASTROENTEROLOGY, INC.
Practice Location Address:

1537 SOUTH BREIEL BOULEVARD
MIDDLETOWN, OH
45044-6703

Practice Phone: 513-425-8300
Practice Fax: 513-425-8301

1235356650 — DR. ELIZABETH J RINGROSE DC
Practice Location Address:

130 COLLEGE ST STE 250
SOUTH HADLEY, MA
01075-1537

Practice Phone: 413-252-9465
Practice Fax: 413-533-0003

1700226149 — ARIA ZAYAS LICSW
Practice Location Address:

225 DEPOT ST
SOUTH EASTON, MA
02375-1537

Practice Phone: 617-947-6227
Practice Fax:

1841159258 — JANDOLYN A DIXON
Practice Location Address:

15616 CHURCH DR
SOUTH HOLLAND, IL
60473-1537

Practice Phone: 312-722-2868
Practice Fax:

1073450631 — WINNI YANG
Practice Location Address:

135 E GROVE ST
SOUTH HACKENSACK, NJ
07606-1662

Practice Phone: 201-981-5290
Practice Fax:

Directions to “SOUTH HACKENSACK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.