Basic Information
Provider Information
NPI: 1588937908
EntityType: 2
ReplacementNPI:  
OrganizationName: BOROUGH OF CRESSKILL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 207
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181050207
CountryCode: US
TelephoneNumber: 4846642007
FaxNumber: 4846642015
Practice Location
Address1: 67 UNION AVE
Address2:  
City: CRESSKILL
State: NJ
PostalCode: 076262130
CountryCode: US
TelephoneNumber: 2015681400
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/15/2012
LastUpdateDate: 02/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCDONALD
AuthorizedOfficialFirstName: HENRY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EMS COORDINATOR
AuthorizedOfficialTelephone: 2019837689
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3416L0300X  Y Transportation ServicesAmbulanceLand Transport

No ID Information.


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