NPIMap

Organization Active NPI

1St Cerebral Palsy of New Jersey

  • Contractor
  • Bloomfield, NJ
National Provider Identifier
1821471418
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
1ST CEREBRAL PALSY OF NEW JERSEY
Practice address
42 State Street
Bloomfield, NJ 07003
Phone
(973) 751-0042
NPI assigned
Jul 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Authorized official

Name
Mr. Patrick Denis Colligan, MPA
Title
Executive Director
Phone
(973) 751-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171W00000X NJ Primary

Addresses

Primary practice location

42 State Street
Bloomfield, NJ 07003

Mailing address

7 Sanford Avenue
Belleville, NJ 07109
Phone (973) 751-0200

Other identifiers 1

IdentifierTypeStateIssuer
3752305MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
1St Cerebral Palsy of New Jersey6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

42 State St
Bloomfield, NJ 07003
Phone (973) 751-0042

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1821471418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SANFORD AVENUE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "07109",
            "telephone_number": "973-751-0200",
            "fax_number": "973-751-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 STATE STREET",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "07003",
            "telephone_number": "973-751-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST CEREBRAL PALSY OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "COLLIGAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "DENIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-751-0200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3752305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 1, 2015; 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.