Provider Demographics
NPI:1831993013
Name:PASSAIC RIVER ROWING ASSOCIATION
Entity type:Organization
Organization Name:PASSAIC RIVER ROWING ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTUNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-283-2069
Mailing Address - Street 1:797 RIVERSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071
Mailing Address - Country:US
Mailing Address - Phone:201-283-2069
Mailing Address - Fax:
Practice Address - Street 1:797 RIVERSIDE AVENUE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071
Practice Address - Country:US
Practice Address - Phone:201-283-2069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No305S00000XManaged Care OrganizationsPoint of Service