Provider Demographics
NPI:1124335047
Name:CYPRESS HEALTH INSTITUTE OF NEW JERSEY
Entity type:Organization
Organization Name:CYPRESS HEALTH INSTITUTE OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-669-2820
Mailing Address - Street 1:PO BOX 599
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-0599
Mailing Address - Country:US
Mailing Address - Phone:973-669-2820
Mailing Address - Fax:973-669-2930
Practice Address - Street 1:405 NORTHFIELD AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3026
Practice Address - Country:US
Practice Address - Phone:973-669-2820
Practice Address - Fax:973-669-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA056219261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care