MEDICARE: HUDSON COUNTY SCHOOLS OF TECHNOLOGY

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)	172295	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629318894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON COUNTY SCHOOLS OF TECHNOLOGY

Provider Business Mailing Address
First Line	:	8511 TONNELLE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-4738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8511 TONNELLE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-4738
Country	:	US
Telephone Number	:	201-662-6662
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS ADMINSTRATOR
Name	:	NICHOLAS FARGO
Credential	:
Telephone Number	:	201-662-6662

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	02/25/2013

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