=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841472677
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OVERLOOK HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2007
-----------------------------------------------------
Last Update Date | 12/04/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33 OVERLOOK RD MAC L05
-----------------------------------------------------
City | SUMMIT
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07901-3570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-522-2570
-----------------------------------------------------
Fax | 908-522-5628
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33 OVERLOOK RD MAC L05
-----------------------------------------------------
City | SUMMIT
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07901-3570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-522-2570
-----------------------------------------------------
Fax | 908-522-5628
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NURSE PRACTITIONER
-----------------------------------------------------
Name | MS. KAREN ANN OLDEN
-----------------------------------------------------
Credential | APRN, FNP, BC, CWON
-----------------------------------------------------
Telephone | 908-522-2570
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 26NN08101500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------