MEDICARE: DENVILLE TOWNSHIP BOE

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
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1467825869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVILLE TOWNSHIP BOE

Provider Business Mailing Address
First Line	:	400 MORRIS AVE STE 279
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-1365
Country	:	US
Telephone Number	:	973-983-6530
Fax Number	:	973-784-4778

Provider Business Practice Location Address
First Line	:	400 MORRIS AVE STE 279
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-1365
Country	:	US
Telephone Number	:	973-983-6530
Fax Number	:	973-784-4778

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	MRS. DAMARIS GUROWSKY
Credential	:
Telephone Number	:	973-983-6530

Provider Enumeration Date	:	11/06/2015
Last Update Date	:	11/06/2015

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