Healthcare Provider Details

I. General information

NPI: 1588665491
Provider Name (Legal Business Name): ATLANTIC COUNTY PUBLIC HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SHORE RD
NORTHFIELD NJ
08225-2319
US

IV. Provider business mailing address

616 W VERNON AVE
LINWOOD NJ
08221-1323
US

V. Phone/Fax

Practice location:
  • Phone: 609-645-7700
  • Fax: 609-272-8490
Mailing address:
  • Phone: 609-601-1763
  • Fax: 609-272-8490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number26NN09780200
License Number StateNJ

VIII. Authorized Official

Name: MS. BARBARA J. KENNEDY
Title or Position: NURSE PRACTITIONER
Credential: APN
Phone: 609-645-7700