Healthcare Provider Details

I. General information

NPI: 1396875316
Provider Name (Legal Business Name): TOWNSHIP OF OCEAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DEAL RD
OCEAN NJ
07712
US

IV. Provider business mailing address

PO BOX 910
OAKHURST NJ
07755
US

V. Phone/Fax

Practice location:
  • Phone: 732-531-2600
  • Fax:
Mailing address:
  • Phone: 732-531-2600
  • Fax: 732-517-8567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number22302
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number22302
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD FRANCIS PONTON
Title or Position: DIRECTOR OF HUMAN SERVICES
Credential: PHD, LPC
Phone: 732-531-2600