Provider Demographics
NPI:1154094597
Name:NP VISITS OF NEW JERSEY, LLC
Entity type:Organization
Organization Name:NP VISITS OF NEW JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASQUALICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:MA ED
Authorized Official - Phone:845-800-9305
Mailing Address - Street 1:17 N PLANK RD STE 10
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2111
Mailing Address - Country:US
Mailing Address - Phone:845-800-9305
Mailing Address - Fax:844-800-1470
Practice Address - Street 1:100 ENTERPRISE DR STE 301
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-2129
Practice Address - Country:US
Practice Address - Phone:602-703-2801
Practice Address - Fax:844-800-1470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty