Ridgewood Nursing Home Health, LLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

26N011880500 Issued in NJ

Legal business name

RIDGEWOOD NURSING HOME HEALTH, LLC

Practice address

11 Zimmer Ave
Midland Park, NJ 07432-1121

Phone

(201) 739-7671

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Havlicek

Title

Registered Nurse

Phone

(201) 739-7671

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558487553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ZIMMER AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321121",
            "telephone_number": "201-739-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ZIMMER AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321121",
            "telephone_number": "201-739-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD NURSING HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAVLICEK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "201-739-7671",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26N011880500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Restifo, L.C.S.W.
• Restore Counseling LLC
• Richard a Guild Edd LLC
• Laura M. Richardson, PH.D.
• Ridgewood Cardiology Associates
• Laura V. Rodriguez-Frank, MD
• Michelle Roglieri, LCSW, MSW
• Mayra Romero, PT, DPT
• Rose Celia Rosato, MA LPC
• Ira Neal Rosenberg, DDS

• Registered Nurse in Midland Park, NJ
• Providers in Midland Park, NJ by specialty
• Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.