Provider Demographics
NPI:1851166425
Name:DPNJ AUTISM SERVICES
Entity Type:Organization
Organization Name:DPNJ AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-503-6334
Mailing Address - Street 1:4 W PALISADE AVE
Mailing Address - Street 2:STE 1064
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2720
Mailing Address - Country:US
Mailing Address - Phone:201-503-6334
Mailing Address - Fax:
Practice Address - Street 1:4 W PALISADE AVE STE 1064
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2720
Practice Address - Country:US
Practice Address - Phone:201-503-6334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-23
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295148377OtherNPI
1558756064OtherNPI
1407638125OtherNPI
1962278564OtherNPI
1487953519OtherNPI
1386235539OtherNPI
1831528124OtherNPI
1194375162OtherNPI