Provider Demographics
NPI:1376528224
Name:VISITING NURSE ASSOCIATION OF ENGLEWOOD, INC.
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF ENGLEWOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYLORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-862-3330
Mailing Address - Street 1:23 MAIN ST STE D1
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2136
Mailing Address - Country:US
Mailing Address - Phone:732-224-6914
Mailing Address - Fax:732-784-9710
Practice Address - Street 1:155 N DEAN ST STE 2C
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2524
Practice Address - Country:US
Practice Address - Phone:201-894-3333
Practice Address - Fax:201-894-1710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22250251E00000X
NJ22745251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4545206Medicaid
NJ372943Medicaid
NJ4145216Medicaid
NJ361364Medicaid
NJ4145208Medicaid
NJ317022Medicare Oscar/Certification
NJ361364Medicaid