Basic Information
| Provider Information | |||||||||
| NPI: | 1982639910 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAYADA NURSES | ||||||||
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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: | 200 CONNECTICUT AVE | ||||||||
| Address2: | SUITE 5-F | ||||||||
| City: | NORWALK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068541940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038545100 | ||||||||
| FaxNumber: | 2038551889 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FLANNERY | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF REIMBURSEMENT | ||||||||
| AuthorizedOfficialTelephone: | 8567931703 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 0011 | CT | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 53A | 01 | CT | ANTHEM BC/BS | OTHER | 0L0714 | 01 | CT | ACS/HEALTH NET | OTHER | 115652 | 01 | CT | CAREMARK, INC | OTHER |