Provider Demographics
NPI:1154654259
Name:COMMUNITIES UNITED HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:COMMUNITIES UNITED HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:862-223-6324
Mailing Address - Street 1:39 CLEREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3126
Mailing Address - Country:US
Mailing Address - Phone:862-223-6324
Mailing Address - Fax:
Practice Address - Street 1:800 BROAD ST
Practice Address - Street 2:SUITE EDISON PL.
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2760
Practice Address - Country:US
Practice Address - Phone:973-242-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051615001041C0700X
NJ44SC013018001041C0700X
NJ37PC00373000225C00000X
NJ46TR00426600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ521121OtherMEDICARE
NJD06927Medicare UPIN
NJ521121OtherMEDICARE