Provider Demographics
NPI:1518152578
Name:TOWNSHIP OF NUTLEY
Entity Type:Organization
Organization Name:TOWNSHIP OF NUTLEY
Other - Org Name:NUTLEY HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-284-4951
Mailing Address - Street 1:149 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2311
Mailing Address - Country:US
Mailing Address - Phone:973-284-4976
Mailing Address - Fax:973-661-9411
Practice Address - Street 1:149 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2311
Practice Address - Country:US
Practice Address - Phone:973-284-4976
Practice Address - Fax:973-661-9411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ534772251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ534772Medicare PIN