Provider Demographics
NPI:1174653505
Name:1ST CEREBRAL PALSY OF NEW JERSEY
Entity type:Organization
Organization Name:1ST CEREBRAL PALSY OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-751-0200
Mailing Address - Street 1:7 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1221
Mailing Address - Country:US
Mailing Address - Phone:973-751-0200
Mailing Address - Fax:
Practice Address - Street 1:7 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1221
Practice Address - Country:US
Practice Address - Phone:973-751-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3066619OtherAETNA
NJ3066619OtherAETNA