MEDICARE: BORO OF EDGEWATER

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	:	1588510390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BORO OF EDGEWATER

Provider Business Mailing Address
First Line	:	251 UNDERCLIFF AVE
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1112
Country	:	US
Telephone Number	:	201-945-4106
Fax Number	:	201-945-4104

Provider Business Practice Location Address
First Line	:	251 UNDERCLIFF AVE
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1112
Country	:	US
Telephone Number	:	201-945-4106
Fax Number	:	201-945-4104

Authorized Official
Title or Position	:	CFO / SCHOOL BUSINESS ADMINISTRATOR
Name	:	MR. JAMES TEVIS
Credential	:
Telephone Number	:	201-945-4106

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/06/2026

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Directions to “BORO OF EDGEWATER ” Practice Location

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