Provider Demographics
NPI:1407723034
Name:SUBURBAN HEALTH CLINIC OF PATERSON
Entity type:Organization
Organization Name:SUBURBAN HEALTH CLINIC OF PATERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SKOKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:856-287-1952
Mailing Address - Street 1:680 BROADWAY STE 1V2
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1524
Mailing Address - Country:US
Mailing Address - Phone:908-258-8765
Mailing Address - Fax:
Practice Address - Street 1:680 BROADWAY STE 1V2
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1524
Practice Address - Country:US
Practice Address - Phone:908-258-8765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty