Provider Demographics
NPI:1285812982
Name:TOWNSHIP OF MONTVILLE
Entity type:Organization
Organization Name:TOWNSHIP OF MONTVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-331-3316
Mailing Address - Street 1:195 CHANGEBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-8934
Mailing Address - Country:US
Mailing Address - Phone:973-331-3316
Mailing Address - Fax:973-331-9287
Practice Address - Street 1:195 CHANGEBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-8934
Practice Address - Country:US
Practice Address - Phone:973-331-3316
Practice Address - Fax:973-331-9287
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTVILLE TOWNSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-05
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
789434Medicare PIN