Provider Demographics
NPI:1942480355
Name:TWP OF MAPLEWOOD HEALTH DEPT
Entity Type:Organization
Organization Name:TWP OF MAPLEWOOD HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:REE
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH OFFICER
Authorized Official - Phone:973-762-8120
Mailing Address - Street 1:574 VALLEY ST
Mailing Address - Street 2:HEALTH DEPT
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2669
Mailing Address - Country:US
Mailing Address - Phone:973-762-8120
Mailing Address - Fax:973-762-2805
Practice Address - Street 1:574 VALLEY ST
Practice Address - Street 2:HEALTH DEPT
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2669
Practice Address - Country:US
Practice Address - Phone:973-762-8120
Practice Address - Fax:973-762-2805
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNSHIP OF MAPLEWOOD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-14
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251K0000X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ429252Medicare PIN