Provider Demographics
NPI:1609280718
Name:PRO STAFF INSTITUTE, LLC
Entity type:Organization
Organization Name:PRO STAFF INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAFFUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-424-7088
Mailing Address - Street 1:265 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2712
Mailing Address - Country:US
Mailing Address - Phone:973-661-1207
Mailing Address - Fax:
Practice Address - Street 1:265 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2712
Practice Address - Country:US
Practice Address - Phone:973-661-1207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy