Mr Ivan Thomas Smalls Jr, is a
Case Manager/care Coordinator based in East Orange, New Jersey. Mr Ivan Thomas Smalls Jr is licensed to practice in * (Not Available) (license number ) and his current practice location is
86 S Harrison St, East Orange, New Jersey. He can be reached at his office (for appointments etc.) via phone at
(973) 324-7891.
NPI number for Mr Ivan Thomas Smalls Jr is 1780338699 and his current mailing address is 86 S Harrison St, East Orange, New Jersey. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1780338699.
Healthcare Provider's Profile
| Full Name | Mr Ivan Thomas Smalls Jr |
|---|
| Gender | Male |
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| Speciality | Case Manager/care Coordinator |
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| Location | 86 S Harrison St, East Orange, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780338699
- Provider Enumeration Date: 02/09/2022
- Last Update Date: 02/09/2022
Medical Identifiers
Medical identifiers for Mr Ivan Thomas Smalls Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780338699 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101Y00000X | Counselor | (New Jersey) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Ivan Thomas Smalls Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Ivan Thomas Smalls Jr,
86 S Harrison St,
East Orange, NJ 07018-1748
Ph: (973) 324-7891 | Mr Ivan Thomas Smalls Jr,
86 S Harrison St,
East Orange, NJ 07018-1748
Ph: (973) 324-7891 |
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