NPIMap

Organization Active NPI

Developmental Disabilities Health Alliance, Inc

Doing business as Developmental Disabilities Health Services, PA

  • Specialist
  • Bloomfield, NJ
National Provider Identifier
1639404486
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA47761 Issued in NJ
Legal business name
DEVELOPMENTAL DISABILITIES HEALTH ALLIANCE, INC
Doing business as
Developmental Disabilities Health Services, PA
Practice address
1285 Broad St
Bloomfield, NJ 07003-3045
Phone
(973) 338-4200
Fax
(973) 338-4440
NPI assigned
Oct 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Authorized official

Name
Theodore A Kastner, M.D, M.SNPI 1942226154
Title
President
Phone
(973) 338-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA47761 NJ Primary

Addresses

Primary practice location

1285 Broad St
Bloomfield, NJ 07003-3045

Mailing address

1285 Broad St
Bloomfield, NJ 07003-3045
Phone (973) 338-4200

Other identifiers 1

IdentifierTypeStateIssuer
8448701MedicaidNJ

Other names 1

  • Developmental Disabilities Health Services, PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Developmental Disabilites Health Alliance2 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

1527 Forest Grove Rd
Vineland, NJ 08360
Phone (856) 697-7490

Practitioners & affiliated clinicians

Practitioners 11

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": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1639404486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033045",
            "telephone_number": "973-338-4200",
            "fax_number": "973-338-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033045",
            "telephone_number": "973-338-4200",
            "fax_number": "973-338-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DISABILITIES HEALTH ALLIANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "KASTNER",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-338-4200",
        "authorized_official_credential": "M.D, M.S"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA47761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8448701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Developmental Disabilities Health Services, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; 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.