Provider Demographics
NPI:1982740403
Name:VISITING HEALTH SERVICES OF NEW JERSEY INC
Entity Type:Organization
Organization Name:VISITING HEALTH SERVICES OF NEW JERSEY INC
Other - Org Name:PASSAIC VALLEY HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-256-4636
Mailing Address - Street 1:783 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1717
Mailing Address - Country:US
Mailing Address - Phone:973-256-4636
Mailing Address - Fax:973-256-6778
Practice Address - Street 1:783 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1717
Practice Address - Country:US
Practice Address - Phone:973-256-4636
Practice Address - Fax:973-256-6778
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISITING HEALTH SERVICES MANAGEMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-30
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22608251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4545109Medicaid
NJ311508Medicare Oscar/Certification