Holy Name Primary Care and Specialty Associates, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

HOLY NAME PRIMARY CARE AND SPECIALTY ASSOCIATES, PC

Practice address

354 Old Hook Rd Ste 102
Westwood, NJ 07675-3247

Phone

(201) 833-3000

NPI assigned

Jul 28, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patricia Beniquez Pacheco

Title

Credentialing Supervisor

Phone

(201) 833-3599

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1013680727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208",
            "telephone_number": "201-833-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 OLD HOOK RD STE 102",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753247",
            "telephone_number": "201-833-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY NAME PRIMARY CARE AND SPECIALTY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "BENIQUEZ PACHECO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "201-833-3599"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.