Provider Demographics
| NPI: | 1366862427 |
|---|---|
| Name: | MERAKEY NEW JERSEY |
| Entity type: | Organization |
| Organization Name: | MERAKEY NEW JERSEY |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CORP SR. DIRECTOR OF BUSINESS OPS |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | NORMAN |
| Authorized Official - Middle Name: | E |
| Authorized Official - Last Name: | TILSON |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 215-836-3131 |
| Mailing Address - Street 1: | 620 GERMANTOWN PIKE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LAFAYETTE HILL |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 19444-1810 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 215-836-3131 |
| Mailing Address - Fax: | 215-273-5975 |
| Practice Address - Street 1: | 906 BETHLEHEM PIKE |
| Practice Address - Street 2: | |
| Practice Address - City: | ERDENHEIM |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 19038-7731 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 215-836-3131 |
| Practice Address - Fax: | 215-273-5975 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2014-04-16 |
| Last Update Date: | 2024-01-29 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 251S00000X | Agencies | Community/Behavioral Health |