Provider Demographics
NPI:1497710800
Name:WARREN CO BD OF CHOSEN FREEHOLDER
Entity Type:Organization
Organization Name:WARREN CO BD OF CHOSEN FREEHOLDER
Other - Org Name:WARREN COUNTY PUBLIC HEALTH NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:908-689-6000
Mailing Address - Street 1:162 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-1849
Mailing Address - Country:US
Mailing Address - Phone:908-689-6000
Mailing Address - Fax:908-689-9057
Practice Address - Street 1:162 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-1849
Practice Address - Country:US
Practice Address - Phone:908-689-6000
Practice Address - Fax:908-689-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0108715Medicaid
NJ3690717Medicaid
NJ600001047OtherRAILROAD
NJ3690709Medicaid
NJ3690709Medicaid
NJ3690717Medicaid