Basic Information
Provider Information
NPI: 1255363016
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA NURSES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 101 EXECUTIVE DR
Address2: SUITE 4
City: MOORESTOWN
State: NJ
PostalCode: 080574236
CountryCode: US
TelephoneNumber: 8567931703
FaxNumber: 8564390412
Practice Location
Address1: 3071 E CHESTNUT AVE
Address2: SUITE C-7
City: VINELAND
State: NJ
PostalCode: 083617847
CountryCode: US
TelephoneNumber: 8566960600
FaxNumber: 8566968429
Other Information
ProviderEnumerationDate: 07/06/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FLANNERY
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: DIRECTOR OF REIMBURSEMENT
AuthorizedOfficialTelephone: 8567931703
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000XHP0015326NJY AgenciesHome Health 

ID Information
IDTypeStateIssuerDescription
000981405NJ MEDICAID
102495801NJHORIZON NJ HEALTHOTHER
6874601NJAETNA/US HEALTHCAREOTHER
A1000801NJMID-ATLANTIC HEALTH PLANOTHER
2562601NJCOVENTRY HEALTH CAREOTHER
81CN5R01NJDDDOTHER
YVPH8N01NJDYFSOTHER
4741201NJKEYSTONE MERCY HEALTH PLAOTHER
A47632501NJOXFORD HEALTH PLANOTHER
00076301NJHORIZON HEALTHCARE - NYOTHER
0L071401NJACS/HEALTH NETOTHER
3754501NJAMERIGROUP NEW JERSEYOTHER
81907401NJHORIZON BC/BS OF NJOTHER
22886501NJMAMSIOTHER
803200Z464610001NJEMPIRE BC/BSOTHER
000446100001NJAMERIHEALTH - NJOTHER
11565201NJCAREMARK, INCOTHER
150490401NJMAGNACAREOTHER


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