Provider Demographics
NPI:1902990880
Name:ZUFALL HEALTH CENTER,INC
Entity Type:Organization
Organization Name:ZUFALL HEALTH CENTER,INC
Other - Org Name:DOVER COMMUNITY CLINIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-328-9100
Mailing Address - Street 1:17 SOUTH WARREN STREET
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-0000
Mailing Address - Country:US
Mailing Address - Phone:973-328-3344
Mailing Address - Fax:973-328-6817
Practice Address - Street 1:17 SOUTH WARREN STREET
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-0000
Practice Address - Country:US
Practice Address - Phone:973-328-3344
Practice Address - Fax:973-328-6817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ80316261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0038750Medicaid
NJ311866Medicare Oscar/Certification