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General NPI Number Information
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NPI Number | 1275723785
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Entity Type | Organization
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Legal Business Name | JANETTE NUTLEY CENTER
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 242 FRANKLIN AVE N/A
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City | NUTLEY
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State | NJ
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Zip | 07110-2709
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Country | US
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Telephone | 973-667-1900
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Fax | 972-667-9194
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Provider Business Mailing Address
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Address Line | 242 FRANKLIN AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-2709
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Country | US
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Telephone | 973-667-1900
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Fax | 972-667-9194
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Authorized Official
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Title or Position | SALES
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Name | MRS. LAURA MAZZOLLA
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Credential | N/A
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Telephone | 973-667-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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