Provider Demographics
NPI: | 1497159511 |
---|---|
Name: | COORDINATED HEALTH NJ, PC |
Entity Type: | Organization |
Organization Name: | COORDINATED HEALTH NJ, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT & COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NYBERG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 610-861-8080 |
Mailing Address - Street 1: | 3435 WINCHESTER RD |
Mailing Address - Street 2: | |
Mailing Address - City: | ALLENTOWN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18104-2268 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 610-861-8080 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 222 RED SCHOOL LN |
Practice Address - Street 2: | |
Practice Address - City: | PHILLIPSBURG |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08865-2219 |
Practice Address - Country: | US |
Practice Address - Phone: | 610-861-8080 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-10-17 |
Last Update Date: | 2020-01-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | Group - Multi-Specialty |
No | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Multi-Specialty |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty |