Provider Demographics
NPI:1295065803
Name:ENVIRONMENTAL AND OCCUPATIONAL HEALTH SCIENCE INSTITUTE.
Entity type:Organization
Organization Name:ENVIRONMENTAL AND OCCUPATIONAL HEALTH SCIENCE INSTITUTE.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOCHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:7324-445-0123
Mailing Address - Street 1:170 FRELINGHUYSEN RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8020
Mailing Address - Country:US
Mailing Address - Phone:732-445-0123
Mailing Address - Fax:
Practice Address - Street 1:170 FRELINGHUYSEN RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8020
Practice Address - Country:US
Practice Address - Phone:732-445-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF MEDICINE AND DENTISTRY, NEW JERSEY.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08648800261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service