Provider Demographics
NPI:1033613971
Name:JEWISH FAMILY SERVICE OF ATLANTIC & CAPE MAY COUNTIES
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE OF ATLANTIC & CAPE MAY COUNTIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-822-1108
Mailing Address - Street 1:607 N JEROME AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-1527
Mailing Address - Country:US
Mailing Address - Phone:609-822-1108
Mailing Address - Fax:609-822-8645
Practice Address - Street 1:607 N JEROME AVE
Practice Address - Street 2:
Practice Address - City:MARGATE CITY
Practice Address - State:NJ
Practice Address - Zip Code:08402-1527
Practice Address - Country:US
Practice Address - Phone:609-822-1108
Practice Address - Fax:609-822-8645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ401040904261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0469688Medicaid