Healthcare Provider Details

I. General information

NPI: 1669698239
Provider Name (Legal Business Name): BOROUGH OF KENILWORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BOULEVARD
KENILWORTH NJ
07033-1654
US

IV. Provider business mailing address

575 BOULEVARD
KENILWORTH NJ
07033-1654
US

V. Phone/Fax

Practice location:
  • Phone: 908-276-2740
  • Fax: 908-276-4813
Mailing address:
  • Phone: 908-276-2740
  • Fax: 908-276-4813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN J FERRAIOLI
Title or Position: HEALTH OFFICER
Credential:
Phone: 908-851-8507