Provider Demographics
NPI:1730483165
Name:BREAST HEALTH AND HEALING, INC
Entity Type:Organization
Organization Name:BREAST HEALTH AND HEALING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:RUDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-250-2710
Mailing Address - Street 1:36 NEWARK AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-4119
Mailing Address - Country:US
Mailing Address - Phone:973-450-2710
Mailing Address - Fax:973-450-2552
Practice Address - Street 1:36 NEWARK AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-4119
Practice Address - Country:US
Practice Address - Phone:973-450-2710
Practice Address - Fax:973-450-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05645200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty