Provider Demographics
NPI:1679725345
Name:BOROUGH OF CALDWELL
Entity Type:Organization
Organization Name:BOROUGH OF CALDWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HUMAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-403-4623
Mailing Address - Street 1:1 PROVOST SQ
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5103
Mailing Address - Country:US
Mailing Address - Phone:973-403-4623
Mailing Address - Fax:973-403-4625
Practice Address - Street 1:1 PROVOST SQ
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5103
Practice Address - Country:US
Practice Address - Phone:973-403-4623
Practice Address - Fax:973-403-4625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB0456320Medicare PIN