Healthcare Provider Details

I. General information

NPI: 1477653319
Provider Name (Legal Business Name): CITY OF NORTH WILDWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NEW JERSEY AVE
NORTH WILDWOOD NJ
08260-2917
US

IV. Provider business mailing address

400 NEW JERSEY AVE
NORTH WILDWOOD NJ
08260-2917
US

V. Phone/Fax

Practice location:
  • Phone: 609-522-5743
  • Fax: 609-729-0722
Mailing address:
  • Phone: 609-522-5743
  • Fax: 609-729-0722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberNONE
License Number StateNJ

VIII. Authorized Official

Name: PAUL EVANGELISTA
Title or Position: FIRE CHIEF
Credential:
Phone: 609-522-5743