Healthcare Provider Details

I. General information

NPI: 1265417018
Provider Name (Legal Business Name): BOROUGH OF MADISON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WALNUT ST MADISON HEALTH DEPARTMENT
MADISON NJ
07940-1638
US

IV. Provider business mailing address

28 WALNUT ST MADISON HEALTH DEPARTMENT
MADISON NJ
07940-1638
US

V. Phone/Fax

Practice location:
  • Phone: 973-593-3079
  • Fax: 973-593-3072
Mailing address:
  • Phone: 973-593-3079
  • Fax: 973-593-3072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberNR50047
License Number StateNJ

VIII. Authorized Official

Name: FLORENCE D RICE
Title or Position: PUBLIC HEALTH NURSE DIRECTOR
Credential: REGISTERED NURSE
Phone: 973-593-3079