Provider Demographics
NPI:1194982702
Name:BLOCK FEDERBUSH & ASSOCIATES LLC
Entity type:Organization
Organization Name:BLOCK FEDERBUSH & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:201-845-9800
Mailing Address - Street 1:16 ARCADIAN AVENUE
Mailing Address - Street 2:SUITE C2
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-845-9800
Mailing Address - Fax:201-845-8663
Practice Address - Street 1:16 ARCADIAN AVENUE
Practice Address - Street 2:SUITE C2
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-845-9800
Practice Address - Fax:201-845-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC48348104100000X
NJ44SC05220100104100000X
NJ44SC05199600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100489Medicare PIN