Provider Demographics
NPI:1013047794
Name:THE COLLEGE OF NEW JERSEY STUDENT HEALTH SERVICES
Entity Type:Organization
Organization Name:THE COLLEGE OF NEW JERSEY STUDENT HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:BAKER
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:609-771-2889
Mailing Address - Street 1:2000 PENNINGTON ROAD
Mailing Address - Street 2:EICKHOFF HALL 107
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-1104
Mailing Address - Country:US
Mailing Address - Phone:609-771-2889
Mailing Address - Fax:609-637-5131
Practice Address - Street 1:2000 PENNINGTON RD
Practice Address - Street 2:EICKHOFF HALL 107
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1104
Practice Address - Country:US
Practice Address - Phone:609-771-2889
Practice Address - Fax:609-637-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health