Provider Demographics
NPI:1104019785
Name:TOWNSHIP OF HILLSIDE
Entity Type:Organization
Organization Name:TOWNSHIP OF HILLSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMINDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-926-4535
Mailing Address - Street 1:1409 LIBERTY AVE
Mailing Address - Street 2:MUNICIPAL BUILDING
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-1345
Mailing Address - Country:US
Mailing Address - Phone:973-926-4535
Mailing Address - Fax:973-926-5589
Practice Address - Street 1:1409 LIBERTY AVE
Practice Address - Street 2:MUNICIPAL BUILDING
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-1345
Practice Address - Country:US
Practice Address - Phone:973-926-4535
Practice Address - Fax:973-926-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ598832Medicare PIN