Provider Demographics
NPI:1225180144
Name:CITY OF BAYONNE
Entity Type:Organization
Organization Name:CITY OF BAYONNE
Other - Org Name:BAYONNE WOMEN'S HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:201-823-1250
Mailing Address - Street 1:564 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:201-823-1250
Mailing Address - Fax:201-823-1140
Practice Address - Street 1:564 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002
Practice Address - Country:US
Practice Address - Phone:201-823-1250
Practice Address - Fax:201-823-1140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF BAYONNE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-18
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ70993261QA0005X
NJ26NN10250000363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8488606Medicaid
NJ001710801Medicaid