Provider Demographics
NPI:1801001300
Name:PATERSON DIVISION OF HEALTH
Entity Type:Organization
Organization Name:PATERSON DIVISION OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:973-321-1277
Mailing Address - Street 1:176 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07505-1115
Mailing Address - Country:US
Mailing Address - Phone:973-321-1277
Mailing Address - Fax:973-278-4916
Practice Address - Street 1:176 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505-1115
Practice Address - Country:US
Practice Address - Phone:973-321-1277
Practice Address - Fax:973-278-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare