SHEANNY VAZQUEZ
Complete NPI Record 1679323455
Community/Behavioral Health in North Bergen, NJ

NPI Status: Active since March 25, 2024

Contact Information

7614 SMITH AVE
NORTH BERGEN, NJ
ZIP 07047
Phone: (201) 681-2365

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Complete NPI Dataset

The following table represents the complete dataset for NPI number 1679323455. The table includes a list of all field names, values and definitions of the full NPI record. This dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1679323455The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code1Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal NameVAZQUEZThe last name of the provider. If the provider is an individual, this is the legal name.
Provider First NameSHEANNYThe first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address7614 SMITH AVEThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameNORTH BERGENThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameNJThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code070474032The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number1201681236The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address7614 SMITH AVEThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNORTH BERGENThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNJThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code070474032The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number2016812365The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date3/25/2024The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date3/25/2024The date that a record was last updated or changed.
Provider Gender CodeFThe code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1251S00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Sole ProprietorYCode indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date3/25/2024