MEDICARE: SOUTH BRUNSWICK TWP. HEALTH DEPT.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	NA	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	052346	OTHER	NJ	RENDERING PROVIDER ID #

General Provider Information

NPI Number	:	1942446018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH BRUNSWICK TWP. HEALTH DEPT.

Provider Business Mailing Address
First Line	:	PO BOX 190
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-0190
Country	:	US
Telephone Number	:	732-329-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 RIDGE RD
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-2643
Country	:	US
Telephone Number	:	732-329-4000
Fax Number	:

Authorized Official
Title or Position	:	HEALTH OFFICER
Name	:	MR. STEPHEN JOSEPH PAPENBERG
Credential	:
Telephone Number	:	732-329-4000

Provider Enumeration Date	:	12/19/2008
Last Update Date	:	12/19/2008

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