Organization Active NPI

City of Newark

Doing business as Newark Dept of Health & Community Wellness- BC

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
National Provider Identifier
1477914612
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
24765 Issued in NJ
Legal business name
CITY OF NEWARK
Doing business as
Newark Dept of Health & Community Wellness- BC
Practice address
30 N Munn Ave # 30a
Newark, NJ 07106-1411
Phone
(973) 877-6111
NPI assigned
Mar 16, 2016
Last updated
Mar 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Oluyinka Fadahunsi, MBA
Title
Financial Operations Officer
Phone
(973) 733-7558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 24765 NJ Primary

Addresses

Primary practice location

30 N Munn Ave # 30a
Newark, NJ 07106-1411

Mailing address

30 N Munn Ave # 30a
Newark, NJ 07106-1411
Phone (973) 877-6111

Other identifiers 1

IdentifierTypeStateIssuer
0390739MedicaidNJ

Other names 1

  • Newark Dept of Health & Community Wellness- BC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
City of Newark Dept of Child and Family Well Being Mobile Medical Van14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1477914612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MUNN AVE # 30A",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071061411",
            "telephone_number": "973-877-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MUNN AVE # 30A",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071061411",
            "telephone_number": "973-877-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEWARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "FADAHUNSI",
        "authorized_official_first_name": "OLUYINKA",
        "authorized_official_title_or_position": "FINANCIAL OPERATIONS OFFICER",
        "authorized_official_telephone_number": "973-733-7558",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NJ",
            "license": "24765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390739",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newark Dept of Health & Community Wellness- BC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 16, 2016; 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.