Provider Demographics
NPI:1609978873
Name:ATWATER INC
Entity Type:Organization
Organization Name:ATWATER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:GOLDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-670-4301
Mailing Address - Street 1:67 BEAVER AVE
Mailing Address - Street 2:SUITE 23
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3071
Mailing Address - Country:US
Mailing Address - Phone:908-735-2040
Mailing Address - Fax:908-735-8888
Practice Address - Street 1:67 BEAVER AVE
Practice Address - Street 2:SUITE 23
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3071
Practice Address - Country:US
Practice Address - Phone:908-735-2040
Practice Address - Fax:908-735-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJATW05008341600000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)