Provider Demographics
NPI:1215093182
Name:COUNTY OF BERGEN NJ
Entity type:Organization
Organization Name:COUNTY OF BERGEN NJ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERSTEIN
Authorized Official - Suffix:III
Authorized Official - Credentials:LICENSED NURSING HOM
Authorized Official - Phone:201-750-8311
Mailing Address - Street 1:35 PIERMONT RD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEIGH
Mailing Address - State:NJ
Mailing Address - Zip Code:07647
Mailing Address - Country:US
Mailing Address - Phone:201-750-8310
Mailing Address - Fax:201-784-3590
Practice Address - Street 1:35 PIERMONT RD
Practice Address - Street 2:
Practice Address - City:ROCKLEIGH
Practice Address - State:NJ
Practice Address - Zip Code:07647
Practice Address - Country:US
Practice Address - Phone:201-750-8310
Practice Address - Fax:201-784-3590
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF BERGEN NJ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-28
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ314000000X
NJ314436314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4465008Medicaid
NJ315436Medicare ID - Type Unspecified