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General NPI Number Information
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NPI Number | 1629155502
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Entity Type | Organization
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Legal Business Name | STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 301 SPRING GARDEN RD
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City | HAMMONTON
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State | NJ
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Zip | 08037-2516
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Country | US
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Telephone | 609-561-1700
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Fax | 609-561-1858
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Provider Business Mailing Address
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Address Line | 301 SPRING GARDEN RD
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City | HAMMONTON
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State | NJ
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Zip | 08037-9699
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Country | US
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Telephone | 609-561-1700
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Fax | 609-561-1858
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DAVID ROAT
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Credential | MD
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Telephone | 609-567-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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