NPIMap

Organization Active NPI

City of Newark

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
National Provider Identifier
1104647635
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CITY OF NEWARK
Practice address
394 University Ave
Newark, NJ 07102-1221
Phone
(800) 734-7083
NPI assigned
Oct 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Ketlen Alsbrook
Title
Ceo & Director
Phone
(973) 733-5310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

394 University Ave
Newark, NJ 07102-1221

Mailing address

110 William St
Newark, NJ 07102-1304
Phone (973) 424-4271

Other names 1

  • Newark Dept of Health and Community Wellness Dental Mobile Unit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
City of Newark Dept of Child and Family Well Being Mobile Medical Van14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1104647635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WILLIAM ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021304",
            "telephone_number": "973-424-4271",
            "fax_number": "973-353-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 UNIVERSITY AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021221",
            "telephone_number": "800-734-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEWARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "ALSBROOK",
        "authorized_official_first_name": "KETLEN",
        "authorized_official_title_or_position": "CEO & DIRECTOR",
        "authorized_official_telephone_number": "973-733-5310"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newark Dept of Health and Community Wellness Dental Mobile Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.