Van Dyk Healthcare, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060227 Issued in NJ

Legal business name

VAN DYK HEALTHCARE, INC.

Doing business as

Van Dyk Manor of Ridgewood

Practice address

304 S Van Dien Ave
Ridgewood, NJ 07450-5200

Phone

(201) 689-7991

Fax

(201) 445-9535

NPI assigned

Oct 19, 2006

Last updated

Jan 7, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Donna M. Melchionda

Title

Chief Financial Officer

Phone

(201) 689-7991

Specialties & licenses 1

Addresses

Other names 1

• Van Dyk Manor of Ridgewood Doing business as

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1710069133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 GOFFLE RD",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075063452",
            "telephone_number": "201-689-7991",
            "fax_number": "973-304-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S VAN DIEN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074505200",
            "telephone_number": "201-689-7991",
            "fax_number": "201-445-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DYK HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "MELCHIONDA",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "201-689-7991",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Dyk Manor of Ridgewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Daniel R Van Engel, MD
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• Skilled Nursing Facility in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.