Provider Demographics
NPI:1083234686
Name:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Entity Type:Organization
Organization Name:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELGA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:848-445-2008
Mailing Address - Street 1:145 BEVIER ROAD
Mailing Address - Street 2:- LSB/HUMAN GENETICS INSTITUTE OF NJ
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8009
Mailing Address - Country:US
Mailing Address - Phone:732-208-7582
Mailing Address - Fax:
Practice Address - Street 1:604 ALLISON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8000
Practice Address - Country:US
Practice Address - Phone:732-445-1498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory