Provider Demographics
NPI:1215702576
Name:CHOICEPOINT LLC
Entity type:Organization
Organization Name:CHOICEPOINT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CORPDEV
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNICELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-273-8090
Mailing Address - Street 1:6586 ATLANTIC AVE # 4872
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23-00 ROUTE 208 STE 2-9
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1558
Practice Address - Country:US
Practice Address - Phone:908-948-8802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOICEPOINT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty