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General NPI Number Information
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NPI Number | 1710181268
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Entity Type | Organization
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Legal Business Name | DEPT. OF VETERAN AFFAIRS NJ HEALTH CARE SYSTEM
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 385 TREMONT AVE
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City | EAST ORANGE
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State | NJ
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Zip | 07018-1023
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Country | US
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Telephone | 973-676-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 101 SUNSET AVE
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City | NORTH ARLINGTON
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State | NJ
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Zip | 07031-5928
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Country | US
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Telephone | 201-997-0777
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Fax |
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Authorized Official
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Title or Position | GPR DIRECTOR
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Name | DR. MICHAEL FERRARA
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Credential | DDS
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Telephone | 973-676-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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