1972017051 NPI number — THE ARC OF ATLANTIC COUNTY, INC.

Table of content: ALYSON E.K. LIPPMAN APN (NPI 1962757419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972017051 NPI number — THE ARC OF ATLANTIC COUNTY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ARC OF ATLANTIC COUNTY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972017051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6550 DELILAH RD STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EGG HARBOR TWP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08234-5102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-485-0800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7128 FERNWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EGG HARBOR TWP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08234-5701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-485-0800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2017

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CLINICAL SERVICES
Authorized Official Telephone Number:
609-485-0800

Provider Taxonomy Codes

  • Taxonomy code: 320900000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0510661 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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