North Jersey AIDS Alliance

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

2000633 Issued in NJ

Legal business name

NORTH JERSEY AIDS ALLIANCE

Practice address

393 Central Avenue C/O Corey Destefano
Newark, NJ 07103

Phone

(973) 483-3444

Fax

(973) 648-0312

NPI assigned

Sep 5, 2017

Organization subpart

No

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

Authorized official

Name

Corey Destefano

Title

Clinical Director

Phone

(973) 483-3444

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NJCRI Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

N Jersey Comm Research Init3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• North Jersey Community Research Initiative

  • Psychiatry Physician
  • Newark, NJ
  • NPI 1639371446
  NPD tax ID
• North Jersey Community Research Initiative

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newark, NJ
  • NPI 1679063242
  NPD tax ID

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982122545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 CENTRAL AVENUE C/O COREY DESTEFANO",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-483-3444",
            "fax_number": "973-648-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 CENTRAL AVENUE C/O COREY DESTEFANO",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-483-3444",
            "fax_number": "973-648-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY AIDS ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DESTEFANO",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "973-483-3444"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NJ",
            "license": "2000633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0562343",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NJCRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Seth Isaac Noorbakhsh, MD
• Akbar Hussain Noormohamed, DO
• Khiara Annaysia Noriega, LSW
• North Bergen Dental Medicine Associates
• North End Family Medical Care Inc.
• North Jersey Community Research Initiative
• North Jersey Community Research Initiative
• North Jersey Community Research Initiative
• North Jersey Orthopaedic Group
• North Plainfield Podiatry

• Substance Use Disorder Rehabilitation Clinic/Center in Newark, NJ
• Providers in Newark, NJ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.