Provider Demographics
NPI:1124352224
Name:TO YOUR HEALTH
Entity type:Organization
Organization Name:TO YOUR HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:973-622-1648
Mailing Address - Street 1:33 LITTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-2031
Mailing Address - Country:US
Mailing Address - Phone:973-622-1648
Mailing Address - Fax:
Practice Address - Street 1:33 LITTLETON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2031
Practice Address - Country:US
Practice Address - Phone:973-622-1648
Practice Address - Fax:973-923-4939
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROVISION OF PROMISE ECONOMIC DEVELOPEMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ305S00000X305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service