Provider Demographics
NPI:1184965881
Name:PITTSGROVE TOWNSHIP
Entity type:Organization
Organization Name:PITTSGROVE TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-358-3094
Mailing Address - Street 1:1076 ALMOND RD
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-3950
Mailing Address - Country:US
Mailing Address - Phone:856-358-3094
Mailing Address - Fax:856-358-7320
Practice Address - Street 1:1076 ALMOND ROAD
Practice Address - Street 2:
Practice Address - City:PITTSGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08318
Practice Address - Country:US
Practice Address - Phone:856-358-3094
Practice Address - Fax:856-358-7320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6700209Medicaid