Provider Demographics
NPI:1578749388
Name:LINCOLN PARK HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:LINCOLN PARK HEALTH DEPARTMENT
Other - Org Name:BOROUGH OF LINCOLN PARK
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SKROBALA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-270-2036
Mailing Address - Street 1:34 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1939
Mailing Address - Country:US
Mailing Address - Phone:973-270-2040
Mailing Address - Fax:
Practice Address - Street 1:34 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035-1939
Practice Address - Country:US
Practice Address - Phone:973-270-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098172Medicare PIN