Provider Demographics
NPI:1528331683
Name:BOROUGH OF FAIR LAWN
Entity type:Organization
Organization Name:BOROUGH OF FAIR LAWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOROUGH ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VANKRUININGEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:201-794-5310
Mailing Address - Street 1:1 COOPERS WAY
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3117
Mailing Address - Country:US
Mailing Address - Phone:201-794-5310
Mailing Address - Fax:201-794-9859
Practice Address - Street 1:1 COOPERS WAY
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3117
Practice Address - Country:US
Practice Address - Phone:201-794-5310
Practice Address - Fax:201-794-9859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJB02110193416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ237298Medicare PIN