Provider Demographics
NPI:1972860740
Name:MARDI & PHILIPS
Entity Type:Organization
Organization Name:MARDI & PHILIPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKETING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENEKAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-675-5600
Mailing Address - Street 1:220 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1401
Mailing Address - Country:US
Mailing Address - Phone:973-675-5600
Mailing Address - Fax:973-675-5601
Practice Address - Street 1:220 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1401
Practice Address - Country:US
Practice Address - Phone:973-675-5600
Practice Address - Fax:973-675-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHPO162900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health