LIFETIME HEALTHCHOICE LLC NPI 1073009338

NPI Information

  • NPI: 1073009338
  • Provider Name: LIFETIME HEALTHCHOICE LLC
  • Classification: Clinic/Center - 261QD1600X
  • Specialization: Developmental Disabilities
  • Entity Type: Organization
  • Address: 134 EVERGREEN PL STE 705
    EAST ORANGE, NJ
    ZIP 07018
  • Phone: (973) 641-8836

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NPI Details

LIFETIME HEALTHCHOICE LLC is a developmental disabilities clinic center in East Orange, NJ. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). LIFETIME HEALTHCHOICE LLC NPI is 1073009338. The provider is registered as an organization entity type.

The provider's business location address is:

134 EVERGREEN PL STE 705
EAST ORANGE, NJ
ZIP 07018-012
Phone: (973) 641-8836
Fax: (973) 695-3795

The provider's authorized official is Dennis Yeboah Kordie .
The authorized official title is Owner/nurse Practitioner and has the following contact phone number (973) 641-8836.

The enumeration date for this NPI number is 7/10/2018 and was last updated on 1/7/2025.

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
1261QD1600XClinic/CenterDevelopmental DisabilitiesYes

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: 11/21/2025

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