Provider Demographics
NPI:1184194359
Name:MATHENY SCHOOL AND HOSPITAL
Entity Type:Organization
Organization Name:MATHENY SCHOOL AND HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADETT
Authorized Official - Middle Name:F
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-234-0011
Mailing Address - Street 1:P.O. BOX 339
Mailing Address - Street 2:
Mailing Address - City:PEAPACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07977-0339
Mailing Address - Country:US
Mailing Address - Phone:908-234-0011
Mailing Address - Fax:908-234-9367
Practice Address - Street 1:65 HIGHLAND AVENUE
Practice Address - Street 2:
Practice Address - City:PEAPACK
Practice Address - State:NJ
Practice Address - Zip Code:07977-0339
Practice Address - Country:US
Practice Address - Phone:908-234-0011
Practice Address - Fax:908-234-9367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0582603Medicaid