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General NPI Number Information
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NPI Number | 1174728471
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Entity Type | Organization
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Legal Business Name | VILLAGE OF SHOREWOOD HEALTH DEPARTMENT
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2010 E SHOREWOOD BLVD
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City | SHOREWOOD
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State | WI
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Zip | 53211-2557
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Country | US
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Telephone | 414-847-2710
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Fax | 414-847-2714
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Provider Business Mailing Address
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Address Line | 3930 N MURRAY AVE
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City | SHOREWOOD
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State | WI
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Zip | 53211-2303
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Country | US
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Telephone | 414-847-2710
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Fax | 414-847-2714
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Authorized Official
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Title or Position | HEALTH OFFICER
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Name | MS. CYNTHIA L. TOMASELLO
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Credential | R.N.,BSN
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Telephone | 414-847-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 55133-030
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License Number State | WI
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