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General NPI Number Information
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NPI Number | 1912063645
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Entity Type | Organization
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Legal Business Name | H J ETZOLD, INC.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 622 EAGLE ROCK AVE STE 201
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City | WEST ORANGE
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State | NJ
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Zip | 07052-2947
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Country | US
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Telephone | 888-422-3044
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Fax | 973-328-3753
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Provider Business Mailing Address
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Address Line | 622 EAGLE ROCK AVE STE 201
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City | WEST ORANGE
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State | NJ
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Zip | 07052-2947
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Country | US
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Telephone | 888-422-3044
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Fax | 973-328-3753
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HERBERT ETZOLD
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Credential |
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Telephone | 973-328-1760
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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 | 000
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License Number State | NJ
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