Provider Demographics
NPI:1508020249
Name:BOROUGH OF BERGENFIELD
Entity Type:Organization
Organization Name:BOROUGH OF BERGENFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-387-4059
Mailing Address - Street 1:198 N WASHINGTON AVE
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1352
Mailing Address - Country:US
Mailing Address - Phone:201-387-4055
Mailing Address - Fax:
Practice Address - Street 1:198 N WASHINGTON AVE
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1352
Practice Address - Country:US
Practice Address - Phone:201-387-4055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC 52659Medicare UPIN