Provider Demographics
NPI:1225531916
Name:JOE ARMENTANO LLC
Entity Type:Organization
Organization Name:JOE ARMENTANO LLC
Other - Org Name:JOE ARMENTANO, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:ARMENTANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:201-212-4999
Mailing Address - Street 1:297 KINDERKAMACK RD STE 212
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1535
Mailing Address - Country:US
Mailing Address - Phone:201-212-4999
Mailing Address - Fax:
Practice Address - Street 1:297 KINDERKAMACK RD STE 212
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1535
Practice Address - Country:US
Practice Address - Phone:201-212-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05570100305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ339727CXXMedicaid