Provider Demographics
NPI:1639619125
Name:WILLIAM PATERSON UNIVERSITY OF NEW JERSEY (WPUNJ)
Entity Type:Organization
Organization Name:WILLIAM PATERSON UNIVERSITY OF NEW JERSEY (WPUNJ)
Other - Org Name:COUNSELING, HEALTH, & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP ADMINISTRATION AND FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLYAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1973-270-2255
Mailing Address - Street 1:358 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2150
Mailing Address - Country:US
Mailing Address - Phone:197-327-0225
Mailing Address - Fax:
Practice Address - Street 1:358 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2150
Practice Address - Country:US
Practice Address - Phone:197-327-0225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty