Provider Demographics
NPI:1508890419
Name:NHCAC
Entity Type:Organization
Organization Name:NHCAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WOMEN'S HEALTH COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LLORENTE
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:201-866-9320
Mailing Address - Street 1:25 N END DR
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-4047
Mailing Address - Country:US
Mailing Address - Phone:201-866-9320
Mailing Address - Fax:201-867-9124
Practice Address - Street 1:5301 BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2622
Practice Address - Country:US
Practice Address - Phone:201-866-9320
Practice Address - Fax:201-867-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00034300261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2151Medicaid