Healthcare Provider Details

I. General information

NPI: 1437264710
Provider Name (Legal Business Name): TOWNSHIP OF BLOOMFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNICIPAL PLZ ROOM 213
BLOOMFIELD NJ
07003-3470
US

IV. Provider business mailing address

1 MUNICIPAL PLZ ROOM 213
BLOOMFIELD NJ
07003-3470
US

V. Phone/Fax

Practice location:
  • Phone: 973-680-4017
  • Fax: 973-680-9017
Mailing address:
  • Phone: 973-680-4017
  • Fax: 973-680-9017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN LORE
Title or Position: DIVISION SUPERVISOR
Credential: MSW
Phone: 973-680-4017