Provider Demographics
NPI:1114517513
Name:SKILLZ OF NEW JERSEY
Entity Type:Organization
Organization Name:SKILLZ OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALNATUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-321-2855
Mailing Address - Street 1:161 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-1773
Mailing Address - Country:US
Mailing Address - Phone:201-321-2855
Mailing Address - Fax:
Practice Address - Street 1:347 E RAILWAY AVE FL 2
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-1217
Practice Address - Country:US
Practice Address - Phone:973-653-9974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Single Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty