Provider Demographics
NPI:1386889178
Name:BOROUGH OF POMPTON LAKES
Entity type:Organization
Organization Name:BOROUGH OF POMPTON LAKES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORAPELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-694-1800
Mailing Address - Street 1:25 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442
Mailing Address - Country:US
Mailing Address - Phone:973-835-0143
Mailing Address - Fax:973-839-8132
Practice Address - Street 1:25 LENOX AVE.
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442
Practice Address - Country:US
Practice Address - Phone:973-835-0143
Practice Address - Fax:973-839-8132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBO413775Medicare PIN