Provider Demographics
NPI:1215191234
Name:CITY OF LINDEN HEALTH DEPT
Entity Type:Organization
Organization Name:CITY OF LINDEN HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOBLIS
Authorized Official - Suffix:
Authorized Official - Credentials:HO
Authorized Official - Phone:908-474-8409
Mailing Address - Street 1:301 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-7218
Mailing Address - Country:US
Mailing Address - Phone:908-474-8409
Mailing Address - Fax:908-474-1836
Practice Address - Street 1:301 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-7218
Practice Address - Country:US
Practice Address - Phone:908-474-8409
Practice Address - Fax:908-474-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ181499Medicare PIN