Active NPI
Blue Balloon New Jersey LLC
- Psychologist
- Kearny, NJ
National Provider Identifier
1346846508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- BLUE BALLOON NEW JERSEY LLC
- Practice address
- 175 Belgrove Dr
Kearny, NJ 07032-1507 - Phone
- (201) 216-9500
- NPI assigned
- Dec 11, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Sussman
- Title
- Member
- Phone
- (201) 216-9500
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
175 Belgrove Dr
Kearny, NJ 07032-1507
Mailing address
175 Belgrove Dr
Kearny, NJ 07032-1507
Phone (201) 216-9500
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607644800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682985600000",
"number": "1346846508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 BELGROVE DR",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321507",
"telephone_number": "201-216-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 BELGROVE DR",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321507",
"telephone_number": "201-216-9500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE BALLOON NEW JERSEY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-11",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A",
"authorized_official_last_name": "SUSSMAN",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "201-216-9500"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kearny, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.