Provider Demographics
NPI:1700505195
Name:COXPHIT LLC
Entity Type:Organization
Organization Name:COXPHIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-655-9105
Mailing Address - Street 1:511 HARMON COVE TOWER
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-1707
Mailing Address - Country:US
Mailing Address - Phone:201-655-9105
Mailing Address - Fax:
Practice Address - Street 1:511 HARMON COVE TOWER # 1
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-1707
Practice Address - Country:US
Practice Address - Phone:201-655-9105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1861865925Medicaid
NJ1225547862Medicaid
NJ1730734583Medicaid