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NPI Code Detail

MEDICARE: STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL

MEDICARE: STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283Q00000XPsychiatric Hospital283Q00000XNJ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1692715OTHERMEDICARE BUILDING GROUP N

General Provider Information

NPI Number : 1336221878
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL
Provider Business Mailing Address
First Line : 59 KOCH AVE
Second Line :
City : MORRIS PLAINS
State : NJ
Zip : 07950-4400
Country : US
Telephone Number : 973-538-1800
Fax Number :
Provider Business Practice Location Address
First Line : 59 KOCH AVE
Second Line :
City : MORRIS PLAINS
State : NJ
Zip : 07950-4400
Country : US
Telephone Number : 973-538-1800
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. JEFFRY R NURENBERG
Credential : MD
Telephone Number : 973-292-4003
Provider Enumeration Date : 10/20/2006
Last Update Date : 03/23/2009

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Practice Location Address:
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1346268562 — MARC CADET MD
Practice Location Address:
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MORRIS PLAINS, NJ
07950-4400
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Practice Fax:
1447353792 — RAKESH S SHARMA MD
Practice Location Address:
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MORRIS PLAINS, NJ
07950-4400
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1093812539 — DR. WALTER MICHAEL BAKUN MD
Practice Location Address:
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Directions to “STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL ” Practice Location

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