Provider Demographics
NPI:1073795860
Name:TOWNSHIP OF ROCKAWAY
Entity Type:Organization
Organization Name:TOWNSHIP OF ROCKAWAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:TABBOT
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, HO
Authorized Official - Phone:973-983-2848
Mailing Address - Street 1:65 MT. HOPE ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-5834
Mailing Address - Country:US
Mailing Address - Phone:973-983-2848
Mailing Address - Fax:973-627-1018
Practice Address - Street 1:65 MT. HOPE ROAD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-5834
Practice Address - Country:US
Practice Address - Phone:973-983-2848
Practice Address - Fax:973-627-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJRO511467Medicare PIN