NPIMap

Organization Active NPI

Elderology, LLC

  • Clinical Social Worker
  • Fanwood, NJ
National Provider Identifier
1790931269
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ELDEROLOGY, LLC
Practice address
31 Carsam St
Fanwood, NJ 07023-1609
Phone
(908) 889-0714
NPI assigned
Aug 15, 2008
Last updated
Aug 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Authorized official

Name
Cynthia Ann Puchammer, MSW, LCSWNPI 1053569756
Title
Executive Director
Phone
(908) 889-0714

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 44SC05307500 NJ
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

31 Carsam St
Fanwood, NJ 07023-1609

Mailing address

31 Carsam St
Fanwood, NJ 07023-1609
Phone (908) 889-0714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091119000048 NJ Part B Supplier - Clinic/Group Practice 6507904141 Receives reassigned benefits from 34 practitioners
Practice locations: Metuchen, NJ

National Provider Directory

National Provider Directory

Locations

61 Pearl St
Metuchen, NJ 08840
Phone (908) 514-8590

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1790931269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CARSAM ST",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231609",
            "telephone_number": "908-889-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 CARSAM ST",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231609",
            "telephone_number": "908-889-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "PUCHAMMER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "908-889-0714",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05307500",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fanwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.