Provider Demographics
NPI:1912179789
Name:BOROUGH OF FORT LEE
Entity Type:Organization
Organization Name:BOROUGH OF FORT LEE
Other - Org Name:FORT LEE HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-592-3500
Mailing Address - Street 1:309 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4705
Mailing Address - Country:US
Mailing Address - Phone:201-592-3500
Mailing Address - Fax:201-585-1901
Practice Address - Street 1:309 MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4705
Practice Address - Country:US
Practice Address - Phone:201-592-3500
Practice Address - Fax:201-585-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ185284Medicare PIN