Healthy Transitions, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

25MA05818600 Issued in NJ

Legal business name

HEALTHY TRANSITIONS, LLC

Practice address

50 Church St Ste L3
Montclair, NJ 07042-2772

Phone

(908) 647-1688

Fax

(908) 647-1688

NPI assigned

Oct 23, 2007

Organization subpart

No

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

Authorized official

Name

Diane Bruessow, PANPI 1063552487

Title

Managing Member

Phone

(908) 647-1688

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diane M Bruessow, PA-C

  • Medical Physician Assistant
  • Florence, MA
  • NPI 1063552487
  NPD Authorized official

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1114116472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHURCH ST STE L3",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422772",
            "telephone_number": "908-647-1688",
            "fax_number": "908-647-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CHURCH ST STE L3",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422772",
            "telephone_number": "908-647-1688",
            "fax_number": "908-647-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY TRANSITIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "BRUESSOW",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "908-647-1688",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NJ",
            "license": "25MA05818600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MA05818600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gregory D Heifler, MD
• Jessica E. Heller, MPS, ATR-BC, LCAT

• Health Service Clinic/Center in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Health Service Clinic/Center in New Jersey

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