Provider Demographics
NPI:1194036376
Name:BOROUGH OF BOGOTA
Entity Type:Organization
Organization Name:BOROUGH OF BOGOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOROUGH ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:NICOLOSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-342-1736
Mailing Address - Street 1:375 LARCH AVE
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1067
Mailing Address - Country:US
Mailing Address - Phone:201-342-1736
Mailing Address - Fax:201-488-2717
Practice Address - Street 1:375 LARCH AVE
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1067
Practice Address - Country:US
Practice Address - Phone:201-342-1736
Practice Address - Fax:201-488-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport