Provider Demographics
NPI:1861676694
Name:BOROUGH OF FLORHAM PARK
Entity Type:Organization
Organization Name:BOROUGH OF FLORHAM PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIROVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-410-5320
Mailing Address - Street 1:111 RIDGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1707
Mailing Address - Country:US
Mailing Address - Phone:973-410-5319
Mailing Address - Fax:
Practice Address - Street 1:111 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1707
Practice Address - Country:US
Practice Address - Phone:973-410-5319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJB2114251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ603123Medicare PIN