Provider Demographics
NPI:1568972339
Name:RARITAN BAY AREA YMCA
Entity Type:Organization
Organization Name:RARITAN BAY AREA YMCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FAMILY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-442-3632
Mailing Address - Street 1:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08862-0148
Mailing Address - Country:US
Mailing Address - Phone:732-442-3632
Mailing Address - Fax:
Practice Address - Street 1:357 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3940
Practice Address - Country:US
Practice Address - Phone:732-442-3632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RARITAN BAY AREA YMCA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty