BRAVE WINGS THERAPY, PC (NPI# 1497304430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497304430 |
| Entity Type | Organization |
| Organization Name | BRAVE WINGS THERAPY, PC |
| Practice Address |
1211 Hamburg Tpke Ste 224 Wayne NJ 07470-5056 |
| Practice Telephone | 9738008515 |
| Mailing Telephone | 9738008515 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | JENNIFER MOORE (CO-DIRECTOR/SLP) |
| Authorized Official Telephone | 9738008515 |
| Authorized Official Credential | EDD CCC-SLP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
1211 HAMBURG TPKE STE 224 |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-5056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144528662 | Jennifer D. Moore | Speech-Language Pathologist | 1211 Hamburg Tpke Ste 224, Wayne, NJ 07470-5056 | 2011-03-08 |
| 1225693849 | Kaitlyn Berninger | Speech-Language Pathologist | 1211 Hamburg Tpke Ste 224, Wayne, NJ 07470-5056 | 2019-05-08 |
| 1942863980 | Sutton Speech LLC | Occupational Therapist | 1211 Hamburg Tpke Ste 224, Wayne, NJ 07470-5056 | 2019-04-16 |
| 1629344494 | Naomi Sutton | Speech-Language Pathologist | 1211 Hamburg Tpke Ste 224, Wayne, NJ 07470-5056 | 2012-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073086 | Brightview Hamburg, LLC | Alzheimer Center (Dementia Center) | 1139 Hamburg Turnpike, Wayne, NJ 07470 | 2020-11-03 |
| 1912536301 | Stevenson Dominique | Physician Assistant | 1700 Nj-23 # 170, Wayne, NJ 07470 | 2020-04-07 |
| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124356530 | Sun Tao Studio L.L.C. | Clinic/Center | 1510 Hamburg Tpke, Wayne, NJ 07470-4079 | 2009-11-23 |
| 1780153338 | Escales Medical Associates At Wayne LLC | Clinic/Center | 342 Hamburg Tpke Ste 101, Wayne, NJ 07470-2166 | 2018-11-13 |
| 1235643313 | Ch Aslam Urgent Pllc | Clinic/Center | 34815 W Michigan Ave Ste 1, Wayne, MI 48184-1895 | 2017-11-28 |
| 1033595152 | North Jersey Healthmed LLC | Clinic/Center | 500 Valley Rd, Suite 101, Wayne, NJ 07470 | 2015-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548880941 | Pjo Health Services LLC | Clinic/Center | 532 Marlton Pike W Ste 380, Marlton, NJ 08053-2075 | 2020-04-26 |
| 1265063846 | Call To Care LLC | Clinic/Center | 523 Park Ave, Orange, NJ 07050-1703 | 2020-01-31 |
| 1679112981 | Passion Care Center of Monmouth | Clinic/Center | 42 Markwood Dr, Howell, NJ 07731-2349 | 2020-01-03 |
| 1063057024 | Hackensack Meridian Nutrition | Clinic/Center | 27 S Cooks Bridge Rd Ste 1-03, Jackson, NJ 08527-2460 | 2019-11-14 |
| 1053960211 | Dua Medical Nj, P.C. | Clinic/Center | 162 Elmora Avenue, Suite 304, Elizabeth, NJ 07202-1148 | 2019-09-10 |
| 1407409360 | Mordecai & Caravello Wellness, LLC | Clinic/Center | 1401 Marlton Pike E Ste 14, Cherry Hill, NJ 08034-2207 | 2019-07-19 |
| 1942767066 | Carerivet Medical Services LLC | Clinic/Center | 26 University Place Blvd, 1st Floor, Jersey City, NJ 07305 | 2019-02-25 |
| 1275097255 | Health Check of Nj LLC | Clinic/Center | 160 Lanza Ave Ste 8, Garfield, NJ 07026-3551 | 2019-01-24 |
| 1164996591 | Comprehensive Medical Associates of New Jersey P C | Clinic/Center | 1000 Harbor Blvd, Weehawken, NJ 07086-6761 | 2019-01-18 |
| 1578036968 | Acupuncture Eden & Wellness Center | Clinic/Center | 221 Sherman Ave Ste A, Berkeley Heights, NJ 07922-1173 | 2019-01-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BRAVE WINGS THERAPY, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.