Active NPI
Martha Jaikissoon
- Social Worker
- Montclair, NJ
National Provider Identifier
1316546534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL06418200
- Practice address
- 622 Valley Rd
Montclair, NJ 07043-1470 - Phone
- (845) 507-6787
- NPI assigned
- Oct 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL06418200 | NJ | Primary |
Addresses
Primary practice location
622 Valley Rd
Montclair, NJ 07043-1470
Mailing address
96 Charles St
Jersey City, NJ 07307-3538
Phone (551) 655-0986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL06418200 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1316546534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 CHARLES ST",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073073538",
"telephone_number": "551-655-0986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 VALLEY RD",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070431470",
"telephone_number": "845-507-6787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIKISSOON",
"first_name": "MARTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-19",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL06418200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.