Healthcare Provider Details

I. General information

NPI: 1538309497
Provider Name (Legal Business Name): BRENDAN W FURLONG MVB EQUINE VETERINARIAN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOMESTEAD ROAD
OLDWICK NJ
08858
US

IV. Provider business mailing address

PO BOX 16
OLDWICK NJ
08858-0016
US

V. Phone/Fax

Practice location:
  • Phone: 908-439-2821
  • Fax: 908-439-2691
Mailing address:
  • Phone: 908-439-2821
  • Fax: 908-439-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number29V100185200
License Number StateNJ

VIII. Authorized Official

Name: DR. BRENDAN WILLIAM FURLONG
Title or Position: VETERINARIAN
Credential:
Phone: 908-439-2821