EAGLE HEALTH SERVICES LLC NPI 1063076685

NPI Information

NPI: 1063076685
Provider Name: EAGLE HEALTH SERVICES, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 31D2184952

Address:
18 FERRY ST
NEWARK, NJ
ZIP 07105
Phone: (732) 255-2252
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EAGLE HEALTH SERVICES, LLC is a psychiatric/mental health nurse practitioner in Newark, NJ. EAGLE HEALTH SERVICES, LLC NPI is 1063076685. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

18 FERRY ST
NEWARK, NJ
ZIP 07105-436
Phone: (732) 255-2252
Fax: (848) 444-9801

The provider's authorized official is David O Alabi .
The authorized official title is Owner and has the following contact phone number (973) 262-4936.

The CLIA number assigned to this NPI record is 31D2184952 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/29/2019 and was last updated on 7/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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