Provider Demographics
NPI:1366836462
Name:DREW UNIVERSITY HEALTH SERVICE
Entity Type:Organization
Organization Name:DREW UNIVERSITY HEALTH SERVICE
Other - Org Name:DREW UNIVERSITY HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAGLIONE
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:973-408-3414
Mailing Address - Street 1:36 MADISON AVE
Mailing Address - Street 2:DREW UNIVERSITY HEALTH SERVICE
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940
Mailing Address - Country:US
Mailing Address - Phone:973-408-3414
Mailing Address - Fax:
Practice Address - Street 1:36 MADISON AVE
Practice Address - Street 2:DREW UNIVERSITY HEALTH SERVICE
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940
Practice Address - Country:US
Practice Address - Phone:973-408-3414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREW UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health