Provider Demographics
NPI:1639428683
Name:UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ
Entity Type:Organization
Organization Name:UNIVERSITY OF MEDICINE AND DENTISTRY OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPT. ACCREDATION AND STANDARD
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-235-3289
Mailing Address - Street 1:671 HOES LANE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:671 HOES LANE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854
Practice Address - Country:US
Practice Address - Phone:732-235-4404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management