Organization
CITY OF NEWARK
Active
Other names
Newark Dept of Health & Community Wellness- BC
Organization subpart
No
Provider details
NPI number
Authorized official
OLUYINKA FADAHUNSI MBA (FINANCIAL OPERATIONS OFFICER)
(973) 733-7558
Entity
Organization
Contact information
Practice address
30 N MUNN AVE # 30A, NEWARK, NJ 07106-1411
(973) 877-6111
Mailing address
30 N MUNN AVE # 30A, NEWARK, NJ 07106-1411
(973) 877-6111
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
24765
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0390739
—
NJ
Enumeration date
03/16/2016
Last updated
03/16/2016
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