Provider Demographics
NPI:1801828736
Name:TOWNSHIP OF IRVINGTON
Entity Type:Organization
Organization Name:TOWNSHIP OF IRVINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MUSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:973-399-6682
Mailing Address - Street 1:1 CIVIC SQ
Mailing Address - Street 2:MUNICIPAL BUILDING
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2412
Mailing Address - Country:US
Mailing Address - Phone:973-399-6682
Mailing Address - Fax:973-399-6766
Practice Address - Street 1:1 CIVIC SQ
Practice Address - Street 2:MUNICIPAL BUILDING
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2412
Practice Address - Country:US
Practice Address - Phone:973-399-6647
Practice Address - Fax:973-371-1489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7317808Medicaid