Provider Demographics
NPI:1437264710
Name:TOWNSHIP OF BLOOMFIELD
Entity Type:Organization
Organization Name:TOWNSHIP OF BLOOMFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LORE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:973-680-4017
Mailing Address - Street 1:1 MUNICIPAL PLZ
Mailing Address - Street 2:ROOM 213
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3470
Mailing Address - Country:US
Mailing Address - Phone:973-680-4017
Mailing Address - Fax:973-680-9017
Practice Address - Street 1:1 MUNICIPAL PLZ
Practice Address - Street 2:ROOM 213
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3470
Practice Address - Country:US
Practice Address - Phone:973-680-4017
Practice Address - Fax:973-680-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJTO760861Medicare PIN
NJBD657335Medicare PIN