Provider Demographics
NPI:1629318894
Name:HUDSON COUNTY SCHOOLS OF TECHNOLOGY
Entity Type:Organization
Organization Name:HUDSON COUNTY SCHOOLS OF TECHNOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FARGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-662-6662
Mailing Address - Street 1:8511 TONNELLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4738
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8511 TONNELLE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4738
Practice Address - Country:US
Practice Address - Phone:201-662-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ172295251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ172295Medicaid