Provider Demographics
NPI:1487836441
Name:BOROUGH OF PALISADES PARK
Entity Type:Organization
Organization Name:BOROUGH OF PALISADES PARK
Other - Org Name:PALISADES PARK HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JADRANKO
Authorized Official - Middle Name:
Authorized Official - Last Name:MIHALINEC
Authorized Official - Suffix:
Authorized Official - Credentials:DIR HEALTH OFFICER
Authorized Official - Phone:201-585-4106
Mailing Address - Street 1:275 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-0000
Mailing Address - Country:US
Mailing Address - Phone:201-585-4106
Mailing Address - Fax:201-585-4107
Practice Address - Street 1:275 BROAD AVE
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-0000
Practice Address - Country:US
Practice Address - Phone:201-585-4106
Practice Address - Fax:201-585-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ185150Medicare PIN