NPIMap

Organization Active NPI

Youth Development Clinic of Newark

  • Community/Behavioral Health Agency
  • Newark, NJ
National Provider Identifier
1316239643
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
YOUTH DEVELOPMENT CLINIC OF NEWARK
Practice address
500 Broad St
3Rd Floor, Suite 1
Newark, NJ 07102-3112
Phone
(973) 623-5080
NPI assigned
May 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Authorized official

Name
Dr. Patricia Connors, M.D.
Title
Ceo
Phone
(973) 623-5080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NJ Primary

Addresses

Primary practice location

500 Broad St
3Rd Floor, Suite 1
Newark, NJ 07102-3112

Mailing address

500 Broad Street
3Rd Floor, Suite 1
Newark, NJ 07102
Phone (973) 623-5080

National Provider Directory

National Provider Directory
Tax ID family
Youth Development Clini2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

500 Broad St
Fl 3
Newark, NJ 07102
Phone (973) 623-5080

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304467200000",
    "number": "1316239643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BROAD STREET",
            "address_2": "3RD FLOOR, SUITE 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-623-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BROAD ST",
            "address_2": "3RD FLOOR, SUITE 1",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023112",
            "telephone_number": "973-623-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH DEVELOPMENT CLINIC OF NEWARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A",
        "authorized_official_last_name": "CONNORS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-623-5080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 4, 2011; 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.