Healthcare Provider Details

I. General information

NPI: 1477532695
Provider Name (Legal Business Name): BOROUGH OF ROSELLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 CHESTNUT STREET
ROSELLE NJ
07203
US

IV. Provider business mailing address

PO BOX 207
ALLENTOWN PA
18105-0207
US

V. Phone/Fax

Practice location:
  • Phone: 908-245-8600
  • Fax: 908-245-7260
Mailing address:
  • Phone: 484-664-2007
  • Fax: 484-664-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberROSE00505
License Number StateNJ

VIII. Authorized Official

Name: PAUL S. MUCHA
Title or Position: FIRE CHIEF
Credential:
Phone: 908-245-8600