Healthcare Provider Details

I. General information

NPI: 1235188830
Provider Name (Legal Business Name): CITY OF PLEASANTVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N 1ST ST
PLEASANTVILLE NJ
08232-2603
US

IV. Provider business mailing address

1 N 1ST ST
PLEASANTVILLE NJ
08232-2603
US

V. Phone/Fax

Practice location:
  • Phone: 609-484-3667
  • Fax: 609-569-1732
Mailing address:
  • Phone: 609-484-3667
  • Fax: 609-569-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberNONE
License Number StateNJ

VIII. Authorized Official

Name: MR. LEROY BORDEN
Title or Position: FIRE CHIEF
Credential:
Phone: 609-484-3667