Provider Demographics
NPI:1477641868
Name:HEALTHY HABITATS, LLC
Entity Type:Organization
Organization Name:HEALTHY HABITATS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:POONAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOOKNANAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-978-7224
Mailing Address - Street 1:15 ZABRISKIE AVE
Mailing Address - Street 2:2E
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-7302
Mailing Address - Country:US
Mailing Address - Phone:201-978-7724
Mailing Address - Fax:
Practice Address - Street 1:15 ZABRISKIE AVE
Practice Address - Street 2:2E
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-7302
Practice Address - Country:US
Practice Address - Phone:201-978-7724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00929300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty