Provider Demographics
NPI:1225572183
Name:KIDZ CAN CORPORATION
Entity Type:Organization
Organization Name:KIDZ CAN CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-668-1251
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08553-0267
Mailing Address - Country:US
Mailing Address - Phone:732-668-1251
Mailing Address - Fax:
Practice Address - Street 1:101 YORK DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7946
Practice Address - Country:US
Practice Address - Phone:732-668-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00364800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health