Van Dyk Healthcare, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060719 Issued in NJ

Legal business name

VAN DYK HEALTHCARE, INC.

Practice address

42 N Mountain Ave
Montclair, NJ 07042-2318

Phone

(973) 783-9400

Fax

(973) 783-8499

NPI assigned

Oct 19, 2006

Last updated

Feb 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Donna M. Melchionda

Title

Chief Financial Officer

Phone

(201) 689-7991

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Van Dyk Manor of Montclair Other name

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1194807412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 GOFFLE RD",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075063452",
            "telephone_number": "201-689-7991",
            "fax_number": "973-304-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N MOUNTAIN AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422318",
            "telephone_number": "973-783-9400",
            "fax_number": "973-783-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DYK HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "MELCHIONDA",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "201-689-7991",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072478",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Dyk Manor of Montclair",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Frances Adele Vadas, LCSW
• Ketaki Vaidhyanathan, M.D.
• John-Eric Vallarta, CRNA
• Ann Frances Vallone, NURSE PRACTITIONER
• Franz Emmanuelle Valmores, MD
• Peggy Van Raalte, PSY.D
• Deborah Diane Vaphides, ACUPUNCTURIST
• Nora Lee Vargas
• Narciza Varzovaite
• Shuba Vasan, BCBA

• Skilled Nursing Facility in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.