Provider Demographics
NPI:1245414903
Name:TOWNSHIP OF WASHINGTON
Entity Type:Organization
Organization Name:TOWNSHIP OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-876-3315
Mailing Address - Street 1:43 SCHOOLEYS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3199
Mailing Address - Country:US
Mailing Address - Phone:908-876-3650
Mailing Address - Fax:908-876-5138
Practice Address - Street 1:43 SCHOOLEYS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3199
Practice Address - Country:US
Practice Address - Phone:908-876-3650
Practice Address - Fax:908-876-5138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076726Medicare PIN