Provider Demographics
NPI:1609407212
Name:ARCHANGEL MICHAEL COPTIC ORTHODOX CHURCH
Entity Type:Organization
Organization Name:ARCHANGEL MICHAEL COPTIC ORTHODOX CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SAMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BASSILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-690-1575
Mailing Address - Street 1:7 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2402
Mailing Address - Country:US
Mailing Address - Phone:732-613-0100
Mailing Address - Fax:
Practice Address - Street 1:7 CHURCH RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2402
Practice Address - Country:US
Practice Address - Phone:732-613-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care